The Assembly met at 13:00 with the Llywydd (Elin Jones) in the Chair.

I call Members to order.

1. Questions to the First Minister

The first item on this afternoon's agenda is questions to the First Minister. The first question is from Michelle Brown, but Michelle Brown is not in Plenary, therefore question 2 will be the first question—Alun Davies.

Question 1 [OAQ55239] not asked.

Public Services

Alun Davies AC: 2. Will the First Minister make a statement on the future development of public services? OAQ55193

Mark Drakeford AC: Austerity remains the force that shapes our public services, driving demand and reducing our ability to respond. This Welsh Government remains committed to public services that are publicly funded and publicly delivered by staff motivated by a powerful sense of public service.

Alun Davies AC: I'm grateful to the First Minister for that. I think many Members, like me, were very pleased to hear the finance Minister making a statement last month on how digital Wales will be moving forward. I was particularly interested, of course, in her view that a digital skills academy will be based in Ebbw Vale, in my constituency, and that we will be investing in chief digital officers across all parts of the Welsh public services, creating a very real cluster of excellence where we can drive digital change. The First Minister will be aware that the economy Minister and the education Minister both visited Thales in Ebbw Vale over the past few weeks to launch the cyber security presence there, which is a part of the Tech Valleys initiative. Will the First Minister, therefore, outline how he sees the cluster in Ebbw Vale, but the wider drive to create digital public services in Wales, moving forward over the next few months, and how we can ensure that this cluster of excellence that we're seeing developed in Ebbw Vale can be the basis and the foundation of further economic growth and excellence in public services?

Mark Drakeford AC: Can I thank Alun Davies for that and for drawing attention to the fact that we are about to recruit a new chief digital officer for the Welsh Government? The current chief digital officer, Llywydd, I'd like to pay tribute to her time in office and wish her well in her retirement. We will bolster that Government-wide post with chief digital officers in local government and in health, and all of that will be put to work alongside the cross-Government ministerial digital board that is chaired by the Minister for Finance and Trefnydd.
Digitisation of public services is one of the key ways in which we know we can go on making a reality of our determination that public services are properly available to citizens right across Wales in a way that matches their contemporary experience. That sense of being in the forefront of the development of digitisation is absolutely what is happening in Ebbw Vale and through the Tech Valleys region, with the work of Thales, with the skills academy, with the centre for digital public services, which will be operational in Ebbw Vale from April 2020, and bringing together there, Llywydd, the infrastructure that we need to support these developments but, very importantly, creating the skills that mean that the workforce in that part of Wales will be well equipped to be at the forefront of these developments.

Delyth Jewell AC: I'd like to ask the First Minister what plans the Welsh Government has to spread prosperity across the country through the development of public services. I think we need to listen to those who feel that we're at risk of imitating England's mistake in overconcentrating power and economic development in one part of the country. Now, one of the ideas that Plaid Cymru has put forward, which I'm sure the First Minister is aware of, is that of a regional renewal Act to decentralise power, ensuring that every part of the country receives its fair share of investment and that public bodies are established in parts of the country that really could do with new jobs.There are parts of my region in the south-east that have experienced depopulation and economic decline that could really do with Welsh Government support—areas like Tredegar, like Merthyr and like Ebbw Vale. Transport links in those areas are so poor and the foundational economy is crying out for investment. So, First Minister, I'd ask how you think the Government can help to improve public services in areas like this so that they can be built back up and be made attractive for businesses to be established there in the future, as well as attracting new local amenities that could boost those communities.

Mark Drakeford AC: I thank the Member for that question. The regional impact of the economy is something absolutely at the forefront of the way in which the Minister for the economy is shaping his policy and his department to deliver in that regionally fair way, although, as the Member's question illustrated, Llywydd, inequalities within regions are more pronounced than inequalities between regions in Wales.
So, making sure that, within a region such as south-east Wales, which has some very prosperous parts of it and some engine-room parts of the Welsh economy—how do we make sure that the fruits of that advance are felt everywhere? That's at the heart of the fair work agenda, it's at the heart of the social partnership Bill that we will bring forward in front of this Assembly and, to revert to Alun Davies's point, digital services have to be viewed through that inequality lens as well.
In that way, I think the way that the Welsh Government approaches these things can be distinguished from the way that these matters have been approached elsewhere in the United Kingdom. We want to create, as the well-being of future generations Act says, a more equal Wales, and that more equal Wales is rooted in equality of opportunity in the economy.

Mandy Jones AC: First Minister, your 2016 manifesto pledge, and I quote, 'We will seek to create stronger, larger local authorities', as Welsh Labour apparently recognised the then vital role that local authorities play in everyone's lives—. Can you provide an update, please, on your reform of local government, or is this promise going to go in the same bin as the M4 relief road?

Mark Drakeford AC: Well, Llywydd, there is a Local Government and Elections (Wales) Bill being presented at this Assembly. It will demonstrate the way in which we will create local authorities that are resilient for the future, retaining the 22 local presences, with a front door that people have become familiar with now over nearly 30 years, and yet to require collaboration on a regional basis for core local government services and activities. In that way, I believe we will marry together the advantages of having local authorities that are close enough to populations for people to feel ownership of them, and a sense of accountability to those populations, with the advantages that regional working for key purposes brings. That Bill will be in front of this National Assembly, and the Member will have every opportunity to contribute to its debate and development.

Questions Without Notice from the Party Leaders

Questions from the party leaders now. Leader of the opposition, Paul Davies.

Paul Davies AC: Diolch, Llywydd. First Minister, the number of confirmed cases of coronavirus in Wales has now risen to six and is expected to rise further. Therefore, it's absolutely crucial that any public information campaign now reaches all parts of Wales so that the public is fully aware of the steps they can take to protect themselves and their families and limit the spread of this virus. What further steps can the Welsh Government take to ensure it maximises the coverage of any public information campaigns in Wales? What additional steps is the Welsh Government taking to ensure that the people of Wales quickly recognise the symptoms of the virus and are properly signposted to the appropriate advice and treatment?

Mark Drakeford AC: I thank Paul Davies for that important question. He's right to say that there are six confirmed cases in Wales at present, but all the evidence and expert advice that we have says that that number will rise. This does give us an opportunity to make sure that the public messaging that we offer is clear, concise and understandable to people.
At yesterday's meeting of the COBRA committee, chaired by the Prime Minister, we agreed that it was important that those messages should be UK-wide. So, many people in Wales, as the leader of the opposition will know, receive the bulk of their news from outlets outside Wales. So, consistency of messaging across the United Kingdom becomes, I think, particularly important in this case, and we will work closely with other UK Governments to make sure that there is no confusion in messaging between different parts of the United Kingdom. Here in Wales, there is already, I think, a very effective symptom checker available through the Public Health Wales website, where, if anybody feels that they need to check what they are experiencing against coronavirus symptoms, it takes them through a series of very simple steps and gives them advice at the end of it. The 111 system now provides advice right across Wales free for people in the coronavirus field, and we will continue to use trusted sources of advice through the NHS and through Public Health Wales to make sure that, where public messaging is being made available, it reaches as many people and as quickly as possible.

Paul Davies AC: First Minister, I understand now that the UK Government has established coronavirus ministerial leads across Government departments, and perhaps you could tell us if the Welsh Government is doing the same to explore all issues and impacts that the virus may have. For example, there's very little guidance or information around the public transport network, particularly given that research published in BMC Infectious Diseases found that those using public transport during flu outbreaks were up to six times more likely to pick up an acute respiratory infection. Of course, there are some very valid concerns around public transport as there are often high numbers of people travelling in overcrowded train carriages, there can be poor ventilation and a lack of hygiene facilities on board as well. And yet travelling on the public transport network is still essential for many people around Wales. Can you therefore tell us what research has the Welsh Government done on the level of threat posed by using the public transport network in its current state? Can you also tell us what discussions the Welsh Government has had with public transport operators across Wales about how they can ensure that passengers are as safe as possible when travelling? And what additional resources are being offered to public transport operators to ensure that they have what they need to ensure that their vehicles and stations are as clean and safe as possible?

Mark Drakeford AC: I thank the leader of the opposition for those questions.
In the Welsh Government, the Cabinet now discusses coronavirus issues at all our meetings, and we have established a core ministerial group that will meet in between regular Cabinet meetings to make sure that we are in a position to respond urgently and immediately where such a response is necessary. The COBRA committee ministerially meets twice a week as well, and Welsh Ministers are always represented at those meetings.
The current best advice that we have from chief scientists and from chief medical officers is that people should continue to use public transport as they would at any other time, and that there are no current difficulties in people doing that. But this is a disease that the evidence tells us is going to develop further, may develop rapidly as we've seen elsewhere in the world, and to return to the first point that Paul Davies made, Llywydd, it is therefore very important that members of the public have access to changing advice, because, as the course of the disease develops, so the position in relation to advice on public transport will develop alongside it.
We operate, as I think we only can, on the best advice that we can get, and we do that on a shared UK basis using the scientific advisory group, the chief scientist and the four chief medical officers. Individual Cabinet colleagues are taking action to contact the sectors for which they are responsible to make sure that those sectors are making preparations for what may need to be faced as the disease develops, whether that is being able to provide a service with fewer staff, because more people will be unwell and fewer people will be in work, or whether it is in responding to physical infrastructure matters of the sort that Paul Davies referred to in relation to public transport.

Paul Davies AC: First Minister, of course, I'm pleased that the UK Government and the Welsh Government have worked together on legislation to strengthen the Welsh Government's powers on matters like quarantining and mass gatherings, and, as you're already aware, some schools in Wales and across the UK have closed their doors to students at risk of coronavirus. Of course, schools are a particular problem in terms of stopping the spread of the virus, and so it's important that there are mechanisms in place for the Welsh Government to close schools, if it needs to.
As the threat of the virus spreading is still high, what preparations have the Welsh Government made for the impact that this could have on schools, colleges and universities across Wales at this stage? What discussions have taken place with Ministers across the UK about developing contingency plans for the education sector and, indeed, the health service, should there be a significant increase in the number of children and young people affected? And what discussions has the Welsh Government had with the nursery and early sector, given that children under five, and especially those under two, are at higher risk due to their lower resilience?

Mark Drakeford AC: Again, I thank the Member for those important questions. We have, indeed, been working with the UK Government on an emergency Bill that is likely to be presented in the House of Commons, and are reaching agreements with other administrations across the United Kingdom on powers that need to come to Wales to deal with devolved services, including the education sector.
We're very aware, Llywydd, that—in what will be an emergency procedure—we will need to work with the Commission to make sure that there are opportunities for the Senedd to scrutinise those proposals as they affect Wales, alongside any LCM that the Government will bring to the floor of the Chamber. The Bill will provide powers for Welsh Ministers in relation to education, and those powers will need to be used at the time when they are most effective.
And if I could just make this one point, Llywydd: in yesterday's COBRA meeting, the point that chief scientists and chief medical officers were most keen to make was that the powers that the emergency Bill will provide need to be deployed at the point when they will make the biggest difference, and shouldn't be used prematurely. Because if you use them prematurely and then need to use them again, the level of public compliance with those measures is likely to decrease. So, if you're going to use powers that are significant, you have to time them properly, and we will act on the best advice that we get from those authorities on timing.
In the meantime, contingency plans, of course, are being developed, and Paul Davies is right to point to the early years sector. Just to give one example of the thinking that is going on: there are regulations, as the Member will know, that in the childcare setting there is a ratio of adults to children, and that ratio is set in regulations. Now, if there are fewer people to work because of the onset of coronavirus, we may need to be more flexible in that regulatory ratio, and that's our thinking and that sort of work is going on already.
And he'll also, finally, Llywydd, be aware that this is a sector that is particularly vulnerable economically because it relies on the fees that it gets from paying parents. What we don't want to see—we've been in dialogue today with the UK Government in advance of tomorrow's budget on this point—is viable and important Welsh businesses going out of business because of a short-term impact, albeit a severe short-term impact, from this condition. We'll be looking to the UK Government to assist in making sure that those businesses can be helped through a difficult period, because we will need them once coronavirus is over.

Plaid Cymru leader, Adam Price.

Adam Price AC: Diolch, Llywydd. First Minister, I believe it's been confirmed that all cases of coronavirus confirmed in Wales had recently returned from Italy. What measures have you taken as a Government to identify Welsh residents who have returned from Italy since the outbreak of the virus, and what extra precautions are in place to ensure that the disease is contained as best as possible?
And also, I was wondering if you could respond to some of the comments made by the shadow Chancellor yesterday when he criticised the speed of action in the response by the UK Government and tardiness on the part of the Chancellor and called for the UK Government to get a grip. To some extent, these comments were echoed by the former Minister Rory Stewart. Do you think that these comments are in any way legitimate concerns at this stage?

Mark Drakeford AC: Llywydd, on the first point, I don't think there is a useable mechanism by which any Government can track people returning to this country from many parts of the world, not just north Italy, other than through the actions that the UK Government has put in place through the ports and airports. We continue to work at a Welsh level where we have some shared responsibility in that regard.
The advice to people who have returned from other parts of the world where coronavirus is in circulation is very clear: they should not simply turn up at a GP surgery or at an accident and emergency service, they should phone first, they should get advice. The Member, I know, is aware that, in Wales, we have had a particular emphasis on home testing for people. We take the test to the person, so that they don't run the risk of coming into contact with people who could then be infected by them.
The six cases that we have identified in Wales so far are, we believe, people who have been in contact with others from another part of the world. We don't think we have, at this point, community spread in Wales, but the advice is that that is a matter of time. So, while we remain in the containment phase, that will develop into a delay set of actions at the right time.
And that takes me to the second point that Adam Price has raised, and it's the point I made in answer to Paul Davies about speed. The advice we were getting yesterday, Llywydd, was that timing of actions is really important. If we move, for example, today, to a regime in which anybody who had the first signs of a cold were asked to self-isolate, it's almost certain that what they would be self-isolating with would be a cold, because colds are in circulation, and coronavirus is not. So, they would stay home for seven days, with all the inconvenience that that causes, for no very good purpose. If, in 10 days' time, coronavirus were to be circulating and we asked them to do it again, the behavioural modelling tells us that people would be more reluctant to do it a second time, having gone through it all once and found that it wasn't serving a useful purpose.
So, while I think there's every right for parliamentarians to challenge the Government, to ask those questions, to be critical where they think criticism is justified, we will work on the basis of the best evidence that we have and, at the moment, we think that the sequencing of the actions that we are likely to have to ask of Welsh citizens is at the right point at this moment, and that we will time any further things we ask of them so that those asks happen at the point where those actions would have the biggest effect in slowing down the spread of the virus.

Adam Price AC: Coronavirus is obviously putting pressure on the NHS in all four nations. Labour's shadow health spokesperson, Jon Ashworth, yesterday asked the health Secretary in England for extra resources because critical care beds in England were at 81 per cent capacity during the week that the latest coronavirus figures were available. The Welsh Government's own task and finish group said:
'NHS Wales has a lower number of critical care beds for the size of the population than the rest of the UK.'
The availability of NHS beds obviously needs to increase drastically, given that hospitals have been operating above the safe level of 85 per cent occupancy for almost 10 years. In the circumstances that we're facing now, have you already identified how you would secure additional critical care beds? And if so, how many?

Mark Drakeford AC: Llywydd, we are looking to the UK Government for extraresource to support the NHS and to support the economy. We'll be looking to the budget tomorrow to see that the assurances that have been given by the Chancellor are turned into more specific figures for us tomorrow. There are more intensive care beds in Wales as a result of the actions of this Government. Many of us here will remember the debate around the organ donation Bill and the need to increase critical care capacity to make a success of that Act.
But I want to try and say to Members in the most sober way that I can, Llywydd, if a realistic worst-case scenario were to emerge in which 80 per cent of the population contracts coronavirus and 25 per cent of the population contracts it in a way that requires significant medical intervention, that is going to place an enormous strain on all our public services, including the health service, because people who work in the health service will be equally affected by the virus. So, we will face a position in which there will be significantly increased demand and real strain on the people who are left to supply it.
So, of course we are working with the health service to identify the plans that can be put in place, the resources that can be mobilised; but these resources won't simply be beds, they will be people to provide the services that are needed. And in a situation where 25 per cent of the population are significantly ill, that will have an impact on those people too. We know that this will be an impact that will be felt over many weeks, and the resilience of the people who we are relying on to come in and respond in an emergency will be difficult to sustain week in and week out over that prolonged period.

Adam Price AC: The cusp of what may turn out to be a global pandemic is obviously not a time when anyone would want to be contemplating closing facilities within the NHS. Five weeks ago, when asked if you would intervene to keep accident and emergency services at Royal Glamorgan Hospital, you said we're not remotely at that point yet. In the next two weeks, the health board will make a final decision. Have we reached that point? And if so, will you intervene today?

Mark Drakeford AC: Llywydd, there is a very well set out and legally necessary process by which a decision arrives on the desk of a Welsh Minister. That is a process in which those organisations that have a legal right to refer a matter to the Minister's desk are the people who have to do that, if they choose to do it. We're not at that point. The health board will have to make its determination, and then an organisation, such as a community health council, who can refer that matter to a Minister for determination, would have to decide to do that. That's how the process works. That's how the process has to work to be legally watertight. And, we're not at that point. We may not get to that point, because the decision has to be referred for a Minister to take a decision. But, if it does happen, Ministers have legal responsibilities. And that's why it has been so important, in all of that, that Ministers don't pre-judge a situation in which any decision they then made would be vulnerable to challenge.

Leader of the Brexit Party, Mark Reckless.

Mark Reckless AC: Diolch, Llywydd. First Minister, if I may turn to flooding, the industry association for forestry businesses, Confor, says that Welsh Government's and NRW's interpretation of the Environment (Wales) Act 2016 resists changes to any landscape where the habitat or designation is not for woodland. Given the flood mitigation benefits of tree planting on uplands, and the opportunities for decarbonisation are there as well, do you agree that guidance for interpreting the Act is now outdated?
In 2017, the Climate Change, Environment and Rural Affairs Committee looked at barriers to tree planting. Confor and Tilhill Forestry were among those who gave evidence, and said that the environmental impact assessments were a huge barrier to tree planting. Since that report, the environmental impact assessment regulations have not changed. Would you agree that it's time we did more to enable tree planting, given the declared climate emergency and the devastating flooding we've recently seen, and should this include updated environment Act regulations and guidance to remove barriers to tree planting?

Mark Drakeford AC: Llywydd, let me begin by agreeing with what the Member has said about the beneficial impact that tree planting can havein relation to flood prevention. Increasing forest cover within river catchments increases canopy evaporation, enhances ground water storage, improves soil structure and resilience, and, very importantly, slows the flow of water. So, there is a strong case that the Member has referred to that additional tree planting has a part to play in flood defences.
There is a balance to be struck between the planting of additional woodland and the impact on biodiversity. Now, because that balance has to be struck, we have a regime in Wales in which, if planting of woodland above five hectares is proposed, then an environmental impact assessment has to be carried out to make sure that the extra tree planting, with its benefits, doesn't crowd out other important objectives in the environmental field. The Minister, I know, is considering at the moment whether that five-hectare threshold is too low, and might be raised. That would have a beneficial impact in making it easier to plant trees, but we would have to be confident that it would not lead to significant biodiversity loss, which might, by itself, outweigh the advantages that the tree planting would bring.

Mark Reckless AC: I welcome the Minister giving that reconsideration. However, Confor also mentioned the issue of where a landscape is designated in some other way, say an upland sort of moorland, that they find there is a presumption against tree planting in those areas. And they can be much cheaper areas, say £1,000 a hectare, rather than several thousand, making the planting much more economic and likely to go ahead. Should we not also look at those designations, and allow greater flexibility for tree planting?
Now, decisions around dredging are affected by the EU water framework directive, and we know that the use of dredging reduced significantly around the time that directive was passed and then implemented. Now, we know that greater dredging would not mitigate all flooding, but it might have made a difference in some cases, for instance, the river Conwy, where we heard from Janet Finch-Saunders. Vikki Howells, from your own benches, made a similar point last week from a south Wales Valleys perspective. Meanwhile, the resumption of dredging the Somerset Levels does seem to have helped in that area. If coupled with regulations that encourage upland tree planting, couldn't increased dredging mitigate future flood risk? Now that we've left the EU, shouldn't we develop our home-made practices and frameworks for dredging and flood protection? And do you agree that these should encourage upland tree planting and make it easier to undertake appropriate dredging?

Mark Drakeford AC: Well, on the first issue of designation, Llywydd, designation is there for a reason; it's for other sorts of protections. But, in a post-Brexit world, the plan that my colleague, Lesley Griffiths has been taking forward that began as 'Brexit and our land' and is now 'Sustainable Farming and our Land', does point to the fact that, in the future, the public will be prepared to pay farmers to do things that have a direct public benefit, and additional tree planting may well be part of one element in the repertoire of things that the public will be prepared to pay for, for the reasons that the Member outlines, and that may have implications for designation.
As for dredging, in our collection of evidence from local authorities, as we begin to move, we hope, into the recovery phase from recent flooding, one of the things we will be discussing with those local authorities is whether dredging, additional dredging, would have had an impact on the flooding that was experienced. So, it's actively under consideration in that evidence-based way, but we will want to hear from each local authority about their particular circumstances. In some places—I am probably wrongly anticipating—but from what I've seen so far, my anticipation is that there will be some instances where additional dredging would make a difference, but that it may not be a solution that has a beneficial impact everywhere.

Local and Community Energy Generation Projects

Mike Hedges AC: 3. Will the First Minister make a statement on Welsh Government support for local and community energy generation projects around Wales? OAQ55191

Mark Drakeford AC: I thank the Member for that question, Llywydd. The Welsh Government has successfully supported local and community renewable energy projects since 2010, and continues to do so through the Welsh Government energy service. We have set challenging local ownership targets to ensure that we are retaining wealth and providing benefit to communities across Wales.

Mike Hedges AC: I thank the First Minister for his answer. I think that one of the things we don't want is our natural resources being turned into wealth in another place rather than Wales.
Energy transmission has changed from power station to end user, now with lots of local generation going to the grid. I remember the diagram that showed a power station in one place, lines going all the way, and ending up in factories and houses. That's not the case now because local generation can go into the grid. But there are two problems that exist. One is: what progress is being made on access to the grid? Because I understand that, in some areas, especially in mid Wales, there's great difficulty in getting access to the grid, and that some areas have got access to the grid because former power stations have closed, and therefore the grid has got greater capacity. And also, local storage and usage. People have heard me talk often about batteries, and the need to make huge developments in batteries. Because, rather than using the grid, if people could generate electricity locally and use it locally, then that would be of benefit to everybody.

Mark Drakeford AC: I thank the Member for both of those important questions. Llywydd, I share something of the frustration that I hear from local generators, of the difficulty in getting National Grid connections. And I spoke about this with the incoming chief executive of Ofgem, in a conversation with him on Friday, and I look forward to him coming to Wales to continue that conversation. And Welsh Government officials are meeting with the National Grid and distribution network operators today. Because we need investment at the UK level, in innovation and cost reduction for storage, and for grid connection. And in some parts of Wales, our opportunities to take advantage of the many natural assets that Wales has for renewable energy generation—whether that's onshore wind or marine—both of those are being held back by the lack of investment in National Grid infrastructure here in Wales. So the Member makes a very important point about that, and about the need for National Grid to attend properly to the needs of Wales.
In relation to battery storage, and innovations of that kind, the Welsh Government wants to play our part in supporting industries that are developing new technologies in that field. My colleague, Ken Skates, has supported an important development in the Neath Port Talbot area that is all about battery storage and the technologies that will allow that sort of local storage on which the ambitions that we have for renewable energy generation here in Wales will depend.

Andrew RT Davies AC: I go back to the days when John Griffiths had this portfolio, and tried to raise this very point about connection to the grid, and the way it's holding back deployment of renewables here in Wales. And indeed, when it comes to battery deployment, there is a moratorium in south Wales until 2026, on any commercial deployment of batteries. So the point about Ofgem's role is well made by the First Minister. It is a fact that we do not have a board member from Wales on the Ofgem board, and, very often, when you interact with Ofgem, they refer to the Government as the Government at Westminster rather than the devolved Governments. Many of the energy responsibilities do reside here, especially planning permissions, et cetera. It is vital that the control period that Ofgem work to when they subsidise infrastructure development has a Welsh angle to it. Do you support Ofgem making a space for a Welsh board member to be appointed, so that Wales's voice can be heard when these decisions are being made?

Mark Drakeford AC: I thank Andrew R.T. Davies for that. Of course we want to improve the answerability of Ofgem to Welsh interests, and the capacity of Ofgem itself to understand and to recognise particular Welsh circumstances. So shall I say that I was heartened by the fact that the incoming chief executive sought a phone call very early on in his tenure, to talk about what they intend to do to improve the service that they provide to Wales? I'm heartened by the fact that he has committed to an early visit to Wales so that he can meet a wider range of Welsh interests. And if a board member from Wales would assist in making sure that we have a better service from the system in the future then, of course, I'll be very happy to take that up with him.

Mental Health Services

Llyr Gruffydd AC: 4. Will the First Minister provide an update on the provision of mental health services in North Wales? OAQ55222

Mark Drakeford AC: May I thank Llyr Gruffydd for the question? Progress continues to be made in many dimensions of mental health care in north Wales. I congratulate staff at Ysbyty Gwynedd and in community hospitals in Betsi Cadwaladr University Health Board on achieving dementia friendly accreditation. Across mental health services, the board acts to prioritise prevention and early intervention in patient care.

Llyr Gruffydd AC: Whilst, of course, there are good news stories such as the ones you’ve mentioned in terms of some of the care, we are aware that one of the reasons that the health board was placed in special measures was because of failings when it comes to mental health services. Now, it was disappointing to read a report last year that was a review of psychiatric therapies in north Wales, which listed a whole host of failings. It mentioned patients having to wait for unacceptably long times; a lack of strategic workforce development; and a lack of data leading to a huge gap in making decisions based on evidence. And in Plaid Cymru’s debate justlast week on this issue, we heard how patients from Wales have been placed in units in England that have been shown by the authorities not to be meeting the standards that we would expect them to meet.
Now, it’s almost five years since the board was placed into special measures, but many of those failings remain. So, the question, of course, is when will you as a Government take responsibility for this list of issues that still haven’t been resolved? Indeed, when will we see the Welsh Government placed into special measures on this issue?

Mark Drakeford AC: Well, Llywydd, of course I acknowledge the fact that problems in the mental health services were part of the reason why the decision was taken to put Betsi Cadwaladr health board into special measures in the first place, but many things have improved in the mental health field over the intervening years since being placed in special measures.

Mark Drakeford AC: On psychological therapies, as the Member will know, this was a report commissioned by the board itself. It will go to the board's quality and safety committee on 17 March. The Welsh Government is providing over £1 million in additional investment directly to the board to act on the recommendations of the report, which it itself commissioned. And, while there are many matters that that report highlights that the board needs to attend to, that report also pointed to many examples where there are innovative, imaginative and committed actions being taken by teams providing psychological therapies in north Wales.
And, as far as patients placed outside Wales are concerned, there is a continuing fall in the number of patients placed in that way. In 2018, 130 patients from across Wales were placed in services in England, and last year, in 2019, that had fallen to 96, and that's as a result of concerted efforts that boards across Wales are making to repatriate services and to bring patients closer to home, and I think that is exactly the right thing for them to do.
Where patients have to be placed across the border—and there will always be examples of very particular need—then we have our own assurance team that visits people in those places, that ensure that even if the service, as a whole, is under scrutiny, that the service provided to that Welsh patient is of a standard that we would be prepared to recognise. And if that is not the case—and let's not forget that in the recent example of St Andrews hospital, it was because of a visit from a Welsh inspector that concerns were raised—then we no longer place patients there and we make alternative arrangements where that is necessary.

Mark Isherwood AC: On 22 January, north Wales community health council wrote to your health Minister, drawing his attention to the report referred to—the independent review of psychological therapies in north Wales, undertaken independently by the TogetherBetter collaborative consultancy—and drawing his attention to its findings of a lack of shared vision, of strategic clarity and oversight at health board and divisional level, a lack of strategic and integrated workforce development, and much more, and said, after nearly five years in special measures, much of it related to mental health services—these findings are deeply disappointing. They also told me that they found the Minister's fairly bland response disappointing too. How do you respond to the contents of the letter I've received from a professor of psychiatry who left Betsi Cadwaladr on 31 January, and who stated that the problems related to the changes proposed by the management of Betsi Cadwaladr University Health Board, after taking on the services in north-west Wales—none of the medical or nursing staff there support it?

Mark Drakeford AC: I've not seen that letter, Llywydd, so I'm not in a position to respond to it. I was aware of the letter from the CHC on 22 January. The Minister's response at the time pointed to the fact that that was a report that was due to be considered by the board, and that it was for the board, as the commissioner of that report, to give it first consideration. As I said in my answer to Llyr Gruffydd, the report is going to the board's quality and safety committee on 17 March and I know that the Minister will want to hear from the board the plan that it will put in place to respond to the recommendations of the report that it itself had commissioned.

Regenerating Newport City Centre

John Griffiths AC: 5. What further steps will the Welsh Government take to work with Newport City Council and other partners to regenerate Newport city centre? OAQ55231

Mark Drakeford AC: I thank John Griffiths for that question, Llywydd. Almost £23 million of regeneration grant and loan funding has been approved for projects in the Newport City Council area since 2014. The Welsh Government continues to work collaboratively with the city council to ensure the successful delivery of their current and future regeneration project.

John Griffiths AC: Thank you for that, First Minister. I do think that that strong partnership between Welsh Government, Newport City Council, business, social landlords and others has borne considerable fruit and helped to meet the challenges of finding alternative uses for our city centre. And soon there will be a further example of that when a substantial four-star hotel opens up in Newport city centre, close to the Friars Walk shopping centre,which itself, of course, was a result of that partnership just a few years ago. But nonetheless, First Minister, there are ongoing challenges, because retail is changing at such a pace, with so much online shopping and so on, so there will be a need to continue and I think strengthen that partnership, and I wonder if you would take the opportunity today to commit to building on the progress made to date by strengthening further that joint working between Welsh Government, Newport City Council, business and social landlords in the city.

Mark Drakeford AC: Llywydd, I'm very pleased to make that commitment, because Newport City Council I think is a real example of a local authority with ambition for the regeneration of its city centre, and a willingness to work in partnership with the Welsh Government, where we are able to provide assistance to them in doing so. There are many examples of this that John Griffiths has referred to, from the Ringland community hub in his own constituency—visited recently by my colleague Hannah Blythyn—to the £17 million Connecting Commercial Street programme. And as I said in my original answer, Llywydd, there are a series of potential further investments in Newport, whether it's the Tirion Homes investment on the former Whiteheads steelworks site—and I'm very pleased to see an application from the city council to the Welsh Government's £5 million fund for green infrastructure and biodiversity in urban areas, and particularly looking forward to working with the city council on the initiative that was announced some weeks ago by the Welsh Government, where we had to provide new powers to local authorities and a £13.6 million fighting fund to tackle blight caused by abandoned buildings in towns and cities across Wales. And I know that Newport council has put forward a number of buildings where they think using the powers and the funding will allow them to regenerate those buildings, to prevent the blight that they currently cause to surrounding areas, and to bring them back into genuinely beneficial use.

Mohammad Asghar (Oscar) AC: First Minister, research by the Local Data Company shows that Wales has the highest shop-closure rates in the United Kingdom. In the first half of the last year, the number of shops in Newport fell by 3.5 per cent. The Welsh Retail Consortium points out that retail accounts for over a quarter of the business rate take in Wales. Although small business rate relief and transitional rate relief are a welcome recognition of the need to keep down costs for firms, three quarters of the retail employment is with firms who do not qualify for this. First Minister, do you agree that the existence of such relief schemes demonstrates the urgent need to reform business rates in Wales to help regenerate city centres such as Newport?

Mark Drakeford AC: Llywydd, I agree that there is a case for the reform of the business rate system. It's why we will bring forward proposals to reform the appeals system. It's why we've agreed to bring forward by a year the re-rating exercise for business properties. But if I understood the Member's suggestion rightly, I would not agree that what we need to do is to reform the help that we offer small businesses in Wales in order to siphon help away from them and to provide it to large multinational retail outlets.
The nature of the retail high street is changing, and it's certainly changing in Newport, and old ways of just trying to make the previous model work faster will not sustain retail into the future. We want to work with the sector to be part of the necessary reform. We want to use the millions and millions of pounds that we invest in rate relief schemes to create sustainable retail businesses for the future.

Recent Flooding

Vikki Howells AC: 6. Will the First Minister provide an update on how the Welsh Government is supporting communities in dealing with the cost of recent flooding? OAQ55190

Mark Drakeford AC: Llywydd, the Welsh Government has put in place a package of support for individuals, businesses and local authorities in the immediate response phase to the flooding. We will consider what further support we can give as more information becomes available, and as things move into the recovery phase.

Vikki Howells AC: Thank you for your response, First Minister, and thank you, more importantly, for the proactive work that you and your Government has carried out. The scale of the damage caused to infrastructure by the recent flooding is becoming all too clear, with, for example, in Rhondda Cynon Taf alone, nine bridges having to be replaced, in addition to damage to roads, culverts and river walls, with an estimated cost to my local authority of £44 million and rising. Now, the UK Government has recognised its responsibility, so isn't it time the Prime Minister puts his money where his mouth is? Will you raise with the UK Government the need for them to provide sufficient financial support to make sure that we can properly repair the damage to infrastructure?

Mark Drakeford AC: Llywydd, of course we're heartened to hear the Prime Minister say in the House of Commons that cash certainly will be passported through to Wales to assist in the recovery phase. My colleague Rebecca Evans raised this directly with the Chief Secretary to the Treasury in London earlier today, and we do look forward—in the budget tomorrow, if possible, but if not then, as urgently as can be thereafter—to receiving more than an assurance, but some hard cash. Because, as Vikki Howells has said, Llywydd, while the Welsh Government has been able to find and to fund, from our resources, help for individuals, businesses and for local authorities in dealing with the immediate impact of the flooding, when it comes to bridges that have been washed away or need to be demolished, roads that will need to be reconstructed, and flood defences that will have to be revisited and re-strengthened, capital investment on that scale is what the United Kingdom is there to help to provide. We look forward to the Prime Minister's assurance turning into the help that local authorities in Wales need.

Janet Finch-Saunders AC: First Minister, of course you will be aware that a number of businesses in Llanrwst were flooded out on 9 February as a result of storm Ciara, yet it was only 4 March 2020 when the Minister for Economy, Transport and North Wales directly announced financial support for businesses. That was nearly a month after the event. Some have ceased trading, some are awaiting insurance payouts, and some have had to turn to savings to continue operating elsewhere. Whilst we all welcomed the £2.5 million support on the day the funding was announced, your Welsh Government explained that
'Further details on how to apply for the fund will be made available in the coming days through...Business Wales.'
This is unacceptable, as is the fact that, as of yesterday, Business Wales was still advising that the application forms for the funding are not available. Will—[Interruption.] Do you mind?

Just ask the—. You need to ask a question, Janet Finch-Saunders.

Janet Finch-Saunders AC: Will you explain, First Minister, why you have betrayed the businesses in Llanrwst, why they've had to wait a month and they've still not seen a penny, and what measures will be taken to improve this access to much-needed funding? It is a disgrace.

Mark Drakeford AC: Well, Llywydd, the Member lets herself down, as she does for the second time in a week. She lets herself down when she uses language of the sort that she did to me in posing that question. There will be help for businesses in her constituency from the Welsh Government. Not a penny from her Government. She talks about a month on. Where was her Government? Where was the money coming from her—? Not a single penny. Let me tell you that. Reflect on that, maybe, when you make these accusations in future.
There is £2.5 million that I am very glad indeed—very glad indeed, Llywydd—that will be made available to businesses in the Member's constituency. They know what they have to do; they have to contact Business Wales. And this is public money, Llywydd. It is absolutely right that Business Wales have to carry out a minimum number of proper checks to make sure that the money goes to the right people in a way that would stand up to scrutiny. Of course that is right. To give you an example, Llywydd, of how quickly help can be made through the discretionary assistance fund: we've now had hundreds and hundreds of payments already made, and hundreds of thousands of pounds in the hands of householders who needed that help. We will do the same with the help that we are providing to businesses and they will know that that help has come to them as a result of the decisions made by this Welsh Government, where her Government has done absolutely nothing.

Leanne Wood AC: I'm sure the people who've been affected by floods, the last thing they want to see is a shouting match in this Chamber.
I welcome the extra £500 that the Government has announced for people without home insurance for flood damage. I'm also grateful for the additional money that has been generously donated by people to the various appeal funds. Money raised throughout the Rhondda by individuals and groups will go directly to those affected, and it's fantastic that I can tell you this afternoon that Trade Centre Wales has donated £50,000 to the fund Rhondda Plaid Cymru established, which will clearly go a long away.
However, there is a disparity between what people in Wales are entitled to compared to what people who've been flooded in England can expect to receive. There they have a property flood resilience scheme that allows flood-hit homes and businesses to apply for up to £5,000 to help them become more resilient to future flooding. This would be so useful in many instances that I've come across, not least for some residents in the Britannia area of Porth, some of whom have had their back walls washed away. Where they used to have a protection against the river, now they're exposed, their gardens and their basements, to the surging River Rhondda. As things stand, those home owners are responsible and residents are not entitled, as far as I'm aware, to any support to remedy this and to protect themselves. As we both agree on the need to futureproof communities from flooding of this kind in the future, will you consider making a similar scheme available in Wales?

Mark Drakeford AC: I thank the Member for that question and, indeed, for the tone in which it was asked, for her recognition of the help that has been provided. I want to absolutely associate myself with what she said about the enormously generous community response that there has been to people in distress.
The funds that we have made available at this point, Llywydd, have been to deal with the immediate impact of the flooding—people whose goods have been destroyed and needed just an immediate cash injection to be able to deal with that impact. As we move into the recovery phase then of course we will look to see what other forms of help might be available. I'm very happy to study the example that the Member has highlighted this afternoon to see if something of that sort can be put in place here in Wales.

Mick Antoniw AC: First Minister, can I first of all thank you for how speedily you came into Treforest in the aftermath of the floods? Now, the Treforest industrial park is an area that has been massively hit: many, many businesses, tens of millions of pounds of damage, and there are many hundreds of jobs that are at stake on that. The first thing I'd say is that the three-month business rate credit that businesses are going to be getting if they've been affected is very much valued. I know that is being funded by Welsh Government, but I would like to make the point of course that there will be some businesses that will take a lot longer to actually be able to get up and running again and I wonder whether there is scope for flexibility where those who have particular difficulties in getting up and running would be able to get, perhaps, further extensions to that. I wonder if that's something you'll give some support to.
The other point I would make is this: there are literally hundreds of jobs at stake in the Treforest industrial area and in this particularly difficult climate we're going through. Had they all been concentrated in one factory there would be immediate packages of support. Of course, with a lot of small businesses, it is a much more complex situation. I wonder if you would actually find time to pay a visit to the industrial estate there to meet with some of the businesses to discuss their particular needs, the support that has been given, but also what may need to be done in order to get that estate up and running and to protect those hundreds of jobs?

Mark Drakeford AC: Llywydd, can I recognise the very particular impact that flooding has had on the Treforest industrial estate? The three-month business rate holiday that the Welsh Government will fund was, again, part of that immediate response package. I will be meeting the leader of Rhondda Cynon Taf council on Thursday of this week to discuss the recovery phase with him, including the recovery that is necessary at Treforest, and will of course take up with him whatever ideas he has and others have to be able to respond to the ongoing difficulty that businesses in that part of Wales face.

Finally, question 7. Jenny Rathbone.

Biodiversity Loss

Jenny Rathbone AC: 7. What is the Welsh Government's strategy for reversing biodiversity loss in Wales? OAQ55214

Mark Drakeford AC: Can I thank the Member for that, Llywydd? Our strategy for reversing the decline in biodiversity encompasses large landscape scale projects such as the national forest, as well as support for the smaller things that all communities and organisations can deliver locally, such as the actions supported by our new Local Places for Nature scheme, launched last month.

Jenny Rathbone AC: Thank you for that, First Minister. I absolutely celebrate the Local Places for Nature scheme, but I first of all just want to highlight the work of WWF, planting seagrass on the Pembrokeshire coastline, which is going to be equivalent to two football pitches and is fantastically good news for about 100,000 fish and 1.5 million invertebrates, because of the way in which it has restorative capacity for our oceans. But I'm afraid I don't have any coastline in my constituency, so looking to—[Interruption.] Yet. [Laughter.] So, looking to the Local Places for Nature initiative, which I think is really fantastic and, obviously, I will be wanting to work with my community, both to try to green the concrete jungle areas of my very inner city areas as well as to get more fruit trees and fruit and vegetables planted across the constituency, I wondered if you can say a little bit more about how the Local Places for Nature scheme, managed by Keep Wales Tidy, is going to operate, because I was a little surprised to see that the deadline for the first round of bids was last Friday, which certainly took me by surprise and really doesn't give ordinary people long enough in order to put together a bid, given that it was only announced at the end of last month.

Mark Drakeford AC: I thank Jenny Rathbone for that, Llywydd. We spent an earlier part of questions today talking about forests and woodland, and the contribution that that can make to the impact of climate change, and the seagrass development today is another very good example of natural responses to what we see going on around us. I will be very interested to see how that develops around Pembrokeshire.
As far as the Local Places for Nature scheme is concerned, I want to pay tribute to Keep Wales Tidy for the work they are doing with us on this. There will be 800 starter packs available through Keep Wales Tidy, Llywydd. They will provide everything that a local community group or a community council might need—tools, bulbs, advice and so on—to allow a community to create their own butterfly, fruit or wildlife garden. There will be an equal number of packages available for all those three things.
And I know—I saw recently that the Member had been out in Plasnewydd in her own constituency carrying out a street audit of green infrastructure in that very densely populated inner city part of Cardiff. This local places scheme is exactly intended to assist those groups who want to do those small things that make a real difference to biodiversity.
The reason why Keep Wales Tidy went for an early first call is because they and we are very anxious to get this money out there doing good things. It will not be the only call that they will make, but we wanted those organisations that were ready to go and had plans in place to get the money as fast as we were able and then to inspire others to do even more.

Thank you, First Minister.

2. Questions to the Counsel General and and Minister for European Transition (in respect of his "law officer" responsibilities)

The next item was to be questions to the Counsel General. Those are postponed until tomorrow.

3. Business Statement and Announcement

The next item, therefore, is the business statement and announcement.

Before I ask the Minister, the Trefnydd, to provide her statement, just to say that I have very many Assembly Members wanting to ask a question. I urge you all, if you want to improve your colleagues' chances of being called this afternoon, to be succinct in your questions. I was particularly lengthy in the First Minister's questions this afternoon, so I want to keep this to a 30-minute statement, if at all possible, in light of what we have ahead of ourselves for today.

With that, Mohammad Asghar.

Mohammad Asghar (Oscar) AC: Thank you, Presiding Officer. May I ask for a statement from the Minister for health about measures to tackle diabetes in Wales? Diabetes in Wales is now a health crisis, with the number of people suffering from the disease having doubled in the last 20 years. Wales has the highest prevalence of diabetes in the United Kingdom, and NHS Wales estimates that 11 per cent of our adult population will have this condition by 2030. Diabetes UK Cymru has welcomed the measures introduced in the Welsh Government's obesity strategy, 'Healthy Weight: Healthy Wales', but says that we need sustained action if we want to support people to lead healthier lives, create a healthier environment and shape a healthier nation. Minister, since Wales is the only country in the United Kingdom without a diabetes prevention programme, please could I ask for a statement from the Minister on what action he will take to address this health crisis in Wales? Thank you.

Rebecca Evans AC: Before I respond to Mohammad Asghar, I probably should set out that there are several changes to this week's business. This week's oral questions—

I'm sorry, I forgot to call you, Trefnydd. [Laughter.]

Rebecca Evans AC: That's all right. This week's oral questions to the Counsel General and Minister for European Transition in respect of his law officer responsibilities will take place tomorrow. The Minister for Health and Social Services will make a statement shortly on coronavirus, COVID-19 update. As a result, the statement on International Women's Day will issue as a written statement. Finally,as a result of the number of amendments tabledand groupings, I have extended the time allocated to Stage 3 proceedings of the Health and Social Care Quality Engagement (Wales) Bill. Draft business for the next three weeks is set out on the business statement and announcement, which can be found amongst the meeting papers available to Members electronically.
In respect of the request for a statement made by Mohammad Asghar, I know that the Minister for Health and Social Services has only recently made a statement to the Assembly on the 'Healthy Weight: Healthy Wales' programme, which did encapsulate some of the concerns that Mohammad Asghar has raised this afternoon. But I would encourage him to also write to the health Minister with his specific concerns about diabetesin order for them to be addressed through correspondence.

Leanne Wood AC: I know that a fair bit of time has been given in the Senedd to debating and scrutinising the Government on its planning and action in terms of the floods, but I've got a number of matters outstanding from my constituency that have so far stalled. I've got a case of a resident flooded in Treorchy who's seen his kitchen flood six, seven, maybe eight times now since the heavy rain began a few weeks ago. Water is gushing into his garden and through his kitchen walls. He believes that a drain has collapsed underneath the main road outside his home, yet the council say it's his responsibility, on his land. I'm wondering if the Government has got any scope to intervene in cases like this.
I've got another case where a resident doesn't have insurance. Their roof was blown off in storm Ciara and then further damaged during storm Dennis. The Government previously said it wants to help people who've been affected by both storms, yet the council have decided that this family isn't eligible for the council funding, which then excludes them from Welsh Government funding and the support that they should be able to access for not being insured. Will the Welsh Government agree to look at cases like this that have been turned down to ensure maximum flexibility within the system to catch cases like this?
I've got many other issues that I'd like to raise but I'm mindful of time, Presiding Officer. If I could just raise one final point, and that's about blocked culverts in general. This is now a huge problem right across the Rhondda. The council don't seem to have the capacity to clear and repair all of the culverts and waterways and, in some cases, these drainage systems need rebuilding. Pentre and Blaenllechau are two good examples of where drainage damage has caused floods into people's homes, but we've also had a house in Llwynypia that was flooded from an overflowing culvert, a street in Ystrad was flooded just last night, and people in homes in Ynyshir are fearful because the culvert drainage system overflowed there again last night. Now, if the council doesn't have the capacity to deal with all of this, can consideration be given to drafting in labour and support from elsewhere? For example, could volunteer groups or even the army be requested to help in situations like this? We need a plan for our waterways and our mountain run-off water; we don't seem to have one now that inspires confidence on the part of the residents that I speak to, who simply can't relax every time it rains.

Rebecca Evans AC: Thank you to Leanne Wood for raising those specific issues of casework that she's received from people affected directly by the flooding, and then that overarching concern about blocked culverts. I will ask Welsh Government officials to speak to Rhondda Cynon Taf council on those issues that you've raised, because, in the first instance, they are matters for the council, but it'd be very important for Welsh Government to understand in more depth the concerns that you've raised. So, I'll make sure that those conversations take place.

Jayne Bryant AC: Trefnydd, could we have a statement on planning procedures in Wales? You may have seen some of the dramatic pictures of my constituent Mr Lee Evans's house perching precariously on the side of the river this week. This happened after the river bank eroded some 30 ft during Storm Dennis. His is one of two properties in this situation, both a part of the Redrow housing development at Carnegie Court in Bassaleg. Planning permission had been turned down by both Newport City Council and the planning inspector. However, this decision was eventually overturned in 2007. Although procedures have since changed, following recent events, questions were obviously being asked about the validity of this process, and I'd welcome a statement detailing why this decision was taken at the time, and, in light of what we now know, will there be a review into how decisions regarding new builds are made in relation to potential flood risks?
Secondly, I'd like to ask for another statement. I was pleased to see the Minister for environment providing a written statement on dog breeding last week. I and many of my constituents are eager to see the end of this distressing and appalling way that some dogs are treated on puppy farms, and this needs to be done urgently. Could we have a statement and a timetable on when that action might be taking place?

Rebecca Evans AC: Thank you to Jayne Bryant for raising her constituent's particular concerns regarding the case of planning permission that you've described, and the issues particularly affecting new build. The Minister with responsibility for planning was here to hear those concerns, and it would be helpful if you could write to the Minister with some further details on the specific case to which you refer in order to give some more consideration to the concerns that you've been able to talk about this afternoon in the Chamber.
In terms of the ways forward for dog breeding, I know that it is the intention of the Minister to bring forward the necessary changes as soon as possible. She's also indicated that she would be looking to legislate within this Assembly term on the issue of puppy sales as well. So, I think that there are important steps ahead of us in terms of improving animal welfare, and particularly dog welfare in Wales, but I will ask for some further clarity on those timescales.

Janet Finch-Saunders AC: Through you, Trefnydd, could I ask the Minister for Economy, Transport and North Wales for a statement on arrangements being put in place in relation to coronavirus on public transport? Public-funded transport such as the flights between Cardiff and Anglesey, TrawsCymru buses and Transport for Wales trains are, of course, places where a significant proportion of people are in an enclosed space for long periods of time. For example, I came down on the train with another Assembly Member yesterday. What I experienced concerned to me greatly. During the four hours, numerous people came and went—I tend to use a table so I can do work on my way down—not once were the tables wiped, and the train, actually, was not very clean. Later on, my Assembly colleague went to the bathroom and I was advised that no hot water or soap was available on the train. Now, you're aware, as am I, that the strong messages coming from Public Health Wales and, indeed, Governments at all levels is the necessity to be able to wash our hands and to maintain strict personal hygiene levels. Will you ask the Minister for that statement? Because I do believe he does have a part to play in terms of giving good advice to our transport operators, so that both they and their staff and, indeed, those travelling on public transport in Wales can feel confident that this matter is being taken very seriously indeed.
Oh, and I have another statement—[Interruption.] Sorry.

Carry on, Trefnydd. No—you've given way to the Trefnydd. The Trefnydd will answer.

Rebecca Evans AC: Okay. So, this is an important issue that the leader of the opposition also had the opportunity to question the First Minister about during First Minister's questions this afternoon, but I will be sure to have this discussion with my colleague the Minister for economy and transport, because the response to coronavirus is very much a cross-Government response and, equally, it's something that every individual in Wales has their part to play in as well.

Dai Lloyd AC: As shadow Minister for international affairs for Plaid Cymru, I've been told the story of a young footballer here in Wales. Can I ask whether the Government will make a statement on the situation of Rolando Bertrand, the 21-year-old and footballer with Bellevue Football Club in Wrexham, who moved to Wales a year ago with his family, but is now at risk of being deported to Nicaragua? He and his family played a part in anti-Government protests, and as a result they believe they've been blacklisted by the Nicaraguan Government. By going back there, it would put his life in danger. So, can I thank the Government for looking into this situation? Thank you.

Rebecca Evans AC: Again, thank you to Dai Lloyd for raising this particular issue. I will certainly explore it myself to better understand the issue. I know that you'll also be making those important representations to the Home Office in respect of their deportation processes and so on, but I'll certainly gather some further information.

Mick Antoniw AC: Trefnydd, I wonder if you could arrange for there to be a Government statement on the action that's being taken by Welsh Government in respect to insurance of properties and businesses in flooded areas. There are houses that were insured, some not insured, some will not be able to get insurance or be able to afford insurance. The same equally applies to businesses. Some of them may now have difficulty gaining insurance or being able to afford insurance, which will obviously affect the viability of businesses and the retention of jobs. I appreciate much of the area around insurance is not a devolved matter, but it seems, working across the UK and with the Association of British Insurers and other interests, there is a real need to review the insurance arrangements and the insurance schemes that exist to protect businesses and residential properties for the future.

Rebecca Evans AC: As the First Minister set out in First Minister's questions earlier on, our first actions have been about giving that initial and immediate response to the impacted households, businesses and communities. But, as we look forward and have the opportunity to reflect on the flooding, there will be these larger questions that we need to explore. With regard to insurance, there is a scheme called Flood Re, which is a joint UK Government and industry partnership, which is there to give households that have been flooded in the past or are at risk of flooding access to affordable insurance. I think that that is a good scheme that perhaps could be well promoted to those households that have been affected by the recent flooding, and those businesses, in order to try and give them some comfort that there is opportunity for insurance in future.

Mark Isherwood AC: Can I call for two statements? First, on the extent of prostate magnetic resonance imaging before biopsy across Wales. Prostate Cancer UK has shared its latest freedom of information request data showing the extent of prostate MRI before biopsy across Wales. This found that three out of seven health boards across Wales are not yet providing the scans to the standards set by the PROMIS trial and recommended by the National Institute for Health and Care Excellence. A further two are offering biparametric MRI, asimplified version of the scans, although they say plans are in place to complete the process of ensuring that all areas are providing access to full multiparametic MRI by 1 April, only a matter of weeks ahead. They also found that there were restrictive eligibility criteria in Abertawe Bro Morgannwg University Health Board and Cwm Taf University Health Board, and that the increase in prostate MRI capacity over the last 12 months was unknown in both Betsi Cadwaladr and Cwm Taf University health boards.
Prostate Cancer UK is therefore calling for radiology units to receive the resources they need to ensure every man who could benefit gets access now, and has developed a planning tool to help health providers calculate the increase in resources they will need to plan for in their areas. I call for a statement accordingly, not to criticise, but to seek a way of closing the bridge, which is a smaller bridge, but action is nonetheless still required.
Secondly and finally, could I call for a statement on forestry and biodiversity? We heard some comments from the First Minister earlier, but, as you'll be aware, the Welsh Government wants woodland cover in Wales to increase by at least 2,000 hectares per annum. When I attended the curlew summit in 10 Downing Street as the Wales species champion for the curlew last July, we heard that widespread planting of conifers in uplands had led to massive habitat loss, and it was not just the planted land that destroyed the birds, but the land in a large area around the forest ceased to be sustainable habitat for ground-nesting birds as the forest provides ideal cover for predators, mostly foxes, carrion crows and badgers. We need to know, therefore, in the context of the commendable goal to increase forestry and woodland in Wales, how we're going to ensure we have the right trees in the right places to genuinely protect biodiversity.

Rebecca Evans AC: I'm grateful to Mark Isherwood for raising those issues. The first was the issue of prostate cancer and those MRItests. I know that there is an intention by the health Minister to bring forward a statement in due course on the cancer strategy, and there'll also be an opportunity to raise issues tomorrow with the Deputy Minister for Health and Social Services during the cancer debate. So, there will be several opportunities in the near future to explore those issues.
On woodland cover, I know that there are particular pieces of work going on across Government, but the particularly interesting and exciting one, I think, is the work going on in terms of the national forest for Wales. I know the Minister will be making a statement very, very shortly—I think the intention is to launch this week.

Llyr Gruffydd AC: I'm pleased that the Minister for agriculture is in her seat, just to note what I intend to raise. The Minister has stated that the new regulations on water quality will be laid within the next few weeks. I don't see in the business statement any reference to an oral statement to run along with the laying of those regulations over the next three weeks' business. You will know, of course, that these regulations have been very contentious, they have been the subject of points raised in this Chamber, and certainly they've produced a huge amount of correspondence for me and many other Members in this Chamber. They make far-reaching changes, and I would expect nothing less than an oral statement to go along with the laying of these new regulations, in order to ensure transparency, an opportunity for scrutiny, and the accountability that should go along with such a statement. So, can I ask you to confirm, Trefnydd, that there will be an oral statement alongside any new regulations laid on water quality, whenever they're brought forward?

Rebecca Evans AC: Llywydd, the Minister is obviously here to hear your request this afternoon. I only have the information in terms of what's been laid on the business statement and announcement today, but we will certainly be listening to the request that you've made this afternoon.

Nick Ramsay AC: I appreciate time is short, so I'll be brief. First of all, an issue raised by a number of Members in this Chamber today: that of flooding. Can I concur with those previous comments in terms of support that's available to businesses and homes, indeed, across Wales? Particularly those homes that may not have access to conventional flood insurance. I visited one home in Monmouthshire, in the town of Monmouth itself, where there's an issue with the electrical sockets, for instance, and there's some cost involved in repositioning those. Perhaps there could be some sort of grant available for those affected by flooding without insurance.
Secondly, an issue I've raised on many occasions: that of roads, and the Chepstow bypass. I wonder if we could have an update at some point in the run-up to Easter from the Minister for transport regarding progressing a Chepstow bypass, and any discussions that might have been held between either himself and his counterpart in Westminster, or indeed the relevant officials, to try and progress that important project.

Rebecca Evans AC: Again, I would highlight the important potential of Flood Re as a potential way forward for people who have found it difficult to get flooding insurance because either they've been flooded in the past and the insurers won't take them on, or because they're on a property that is deemed to be at risk of flooding. It is a Government and industry partnership in order to deliver that, to ensure that people do have access to affordable insurance in those circumstances. So, I'd recommend that to Members, to explore it further as to whether it's something that they can explore with their constituents.
And of course, I will speak to my colleague the Minister for transport with regard to the request for an update on the Chepstow bypass.

Delyth Jewell AC: Two months ago, I asked for a Government statement about health workforce planning, because I was concerned that a number of GP surgeries in my region were at risk of closure. Local councillors who also raised the issue were accused of scaremongering, but last week we received confirmation that three surgeries are to close in Gilfach, Lansbury Park and Penyrheol, all managed by Aneurin Bevan health board and all in the Caerphilly County Borough Council area.
I'm really concerned that the surgeries that will now have to take on thousands of new patients in light of these closures will struggle to deal with the extra demand, and that some people will have to travel to very far away places if they don't have their own transport. They might have trouble re-registering and accessing the new surgeries. I was out talking to residents in Lansbury Park last week, and one constituent told a colleague of mine that he was only just able to walk to a surgery round the corner, but he didn't know how he was going to be able to reach somewhere that was much further away.
I've previously mentioned that the BMA GP heat-map analysis showed that 32 surgeries are at risk of closure in the Aneurin Bevan health board area. Three of these have now closed, or are about to close, which means a further 29 could still be at risk.
My previous request for a statement went unheeded, I'm afraid. So, I'd like to ask again for a statement from the Welsh Government setting out what support will be made available to patients, pharmacies and surgeries that will have to cope with these new closures? Secondly, what immediate steps will the Welsh Government take to prevent the closure of further surgeries in their region through timely recruitment? And finally, how does the Welsh Government intend to turn around this disastrous failure to plan its future GP workforce in the face of growing demand? Diolch, Trefnydd.

Rebecca Evans AC: Health boards are working with partners throughout the clusters to adopt and adapt the primary care model for Wales, with its focus on support for self-care and delivering a seamless 24/7 service that prioritises the sickest people, making effective use of the multiprofessional workforce. And of course, this year, the Welsh Government has provided an additional £10 million for clusters to decide how to invest in the support of the primary care model for Wales.
With regard to the specific GP practices to which you refer, I do know that the Minister has had some discussions with the local Members, and that the health board is now offering a package of support to each of those practices that are likely to see an increased number of patients. Of course, there's huge work going on, isn't there, to try and encourage people to work in Wales, and actually, successful work in terms of recruiting new GPs into the training programmes as well. But the Minister has heard your request for a statement. It's very difficult to accommodate all statements; we get about 20 or so requests every week, with only a small number of slots in which to respond to them, but we do our best to try and accommodate things as much as we can.

Thank you, Trefnydd.

4. Statement by the Deputy Minister and Chief Whip: International Women's Day

The next item, a statement on International Women's Day, has been tabled as a written statement.

5. Statement by the Minister for Health and Social Services: Coronavirus (COVID-2019) update

Therefore, the next item is a statement by the Minister for Health and Social Services, a coronavirus update. I call on the Minister to make the statement—Vaughan Gething.

Vaughan Gething AC: Thank you, Llywydd.The situation in Wales continues to evolve and we now have six confirmed cases. More cases will be diagnosed both here and elsewhere the UK in the coming days. In response to the changing situation, we have jointly developed an action plan with the UK Government and the other national devolved Governments. This builds on our experience of treating infectious diseases and our planning for an influenza pandemic.
The action plan deals with what we know currently about the virus and the diseases it causes; how we have planned for an infectious disease outbreak such as coronavirus; the actions we have taken so far in response to the current outbreak; what we're planning to do next, depending on the course that the current outbreak takes; and, of course, the role that the public can play in supporting this response, now and in the future.
I have asked the chief executive of NHS Wales to establish anNHS Wales and social services planning and response team to draw on appropriate expertise and to be in the best position to address response issues as we move through the phases of this outbreak. This team will provide ongoing support, co-ordination and integration of the health and social services response. They will co-ordinate their work with the wider remit of the Welsh Government emergency co-ordination centre.As an immediate action, assurance has been sought and confirmed from all health boards with acute hospitals that they are ready to accept patients into their isolation facilities.
This weekend, I authorised the supply of personal protective equipment to all GP practices across Wales. Supplies of personal protective equipment to community pharmacies will be sent out later this week. We are mobilising our pandemic stockpiles for health and social care, so that this stock is in a state of readiness to be pushed out as and when necessary.
We are still taking action to detect early cases, to follow up close contacts, and to prevent the disease taking hold in this country for as long as is practically possible. If the disease becomes more established in the UK and in Wales, we will need to consider further measures to reduce the rate and extent of its spread.
We will therefore look to take new powers for Wales through the UK-wide coronavirus Bill to be introduced in the House of Commons, to be able to help systems and services work more effectively in tackling the outbreak. The Bill will strengthen quarantine and mass gathering powers, and will allow for the closure of schools and colleges, if necessary, to contain the spread of coronavirus. All four UK Governments across the UK have agreed on a single piece of UK-wide legislation as the right approach. However, I do want to reiterate the point that, in that single piece of UK-wide legislation, it is a clear expectation that all those powers that are currently devolved responsibilities will remain the responsibilities of Ministers in devolved national Governments.

Vaughan Gething AC: Our NHS will have to make some changes to how it operates. That includes care and advice by phone and information technology. I have decided on a new software system to be made available across Wales to enable video consultations for people with their GPs. We have already introduced an online symptom checker, hosted by our NHS Direct Wales website. There is, of course, the daily update on the Public Health Wales website too. This should help to reduce pressure on front-line staff, and better support people with information and advice.
We want to strike a balance between keeping people safe and minimising the social and economic impact. Our decisions will reflect the scientific evidence, and take into account the trade-offs involved. The actions we will consider include encouraging greater home working, not using public transport and other behavioural measures that people can voluntarily take to slow the spread of the disease. We will consider if those with more minor symptoms should self-isolate, but this will be informed by expert advice on the epidemiology of the outbreak, and we are not at that point today.
It is worth reminding ourselves and the public, though, that people with significant flu-like symptoms should not attend work, their GP, or an A&E department. That is not new advice—that is the current advice at all times of the year.
Some major public events, as we've seen, have been cancelled or postponed outside Wales, to limit the risk of transmitting coronavirus. A number of schools have closed in other countries for similar reasons. These are possible future options for us too. We are, however, not at that stage. Schools should remain open, and there is no rationale to cancel major sporting fixtures at this point.
But some of the most effective measures involve all of us—not just the Government or the NHS. For instance, simple personal hygiene procedures can significantly limit the spread of the virus, as can prudent self-isolation for those at particular risk. Employers can and should support their staff to take such action, without creating undue alarm. To mitigate the impact on businesses, the Welsh Government has registered COVID-19 as a notifiable disease. This will help companies seek compensation through their insurance policies in the event of any cancellations that they may have to make as a result of the spread of the virus.
We are moving towards enhanced monitoring arrangements at Cardiff international airport. This will mean that every aircraft that lands here from a region identified by the case definition will need to declare any symptomatic passengers to Public Health Wales's port health teams before disembarking.
Outside the UK, the risk changes daily. The Foreign and Commonwealth Office also updates its advice to travellers regularly. And people who intend to travel abroad should check the Foreign and Commonwealth Office website for the most up-to-date travel advice before they travel. The latest advice for returning travellers from the highest-risk parts of the world is to stay indoors, avoid contact with other people, and call 111. That is true even if they do not have symptoms. Those areas are: Iran, the Hubei province in China and Italy. For returning travellers from areas that are deemed lower risk, the advice is to stay indoors and avoid contact with other people only if you develop symptoms. This now includes all of Italy outside of the locked down areas I've already mentioned.
There is further advice available from Public Health Wales and the Welsh Government for people who have not travelled but are nonetheless concerned. That too will change as the pattern of the outbreak changes and as our understanding grows. But following such advice is always better than listening to often ill-informed rumour and speculation. In particular, I would urge people to check the advice that is available before presenting themselves for diagnosis, which, of course, risks wasting finite NHS resources. We are continuing to offer community testing to people in their own homes. In addition, 111 is now available across all areas of Wales for coronavirus advice.
The First Minister and I continue to attend COBRA meetings. We will continue to work with UK Ministers, the Scottish and Northern Irish Governments, our chief medical officers, and public health agencies, across all four nations.
No-one should be under any illusion about the threat that the coronavirus presents. There are plain and serious risks to people's health, including in particular people who are already vulnerable. And a large-scale outbreak also carries wider risks of social and economic disruption.
This outbreak will not go away quickly and it will get worse before it gets better. But, at the same time, we have long been prepared for an outbreak like this, and we are learning more about this particular virus each day. That knowledge, combined with the dedication of our health professionals and others right across public services and the independent sector, allows us to reduce the risks as far as we possibly can.I will, of course, keep Members and the people of Wales fully informed of any steps that we take here in the Government.

Angela Burns AC: Thank you very much for your statement, Minister, and for keeping me, on behalf of the Welsh Conservatives, so well briefed during this situation. Just going through your statement, I have a number of questions. Are you able to confirm to us the level of seniority that the members of the NHS Wales and social services planning and response teams will be—in other words, that they've got the stripes to make things happen out there in the NHS? Are you able to confirm to us how many isolation beds we currently have available throughout our whole NHS? Because I'm assuming that isolation is literally quite different from intensive care, because they're the ones within the walled glass environments, so I just wanted clarification on that.
I was very pleased to see the personal protective equipment going out to GP practices and pharmacies, and I wondered at what point you might consider issuing them to domiciliary care workers and to care workers in residential homes, and what advice you might be giving to owners of private homes as to what precautions that they should be taking.
You were talking about the technology to underpin this, and I must say that the symptom checker is very good, because I tried it out, and I think it's very clear and I commend you for that. Of course, an awful lot of older people will not necessarily have access to IT or be able to use IT, and I wondered what you might be putting in place, or what instructions you will be giving to older persons who can't actually use a symptom checker and what they shoulddo. I'm assuming you might say back to me '111', and, again, I just wanted to have some clarification on that, because I was up in Wrexham Maelor Hospital meeting staff last week, and I also met with a couple of GP practices, and they were quite confusing on their message back to me as to the efficiency of 111 in north Wales. There was talk about the 0845 number being on a divert and that they weren't convinced that actually 111 was universal. So, perhaps, you could just confirm that, so that we can move forward on that one.
And, again, while we're on the subject of older people, I appreciate that this isn't for now, but in the weeks coming up, will you be talking to and have you had any discussions with organisations such as supermarket leaders, to perhaps put in place some kind of way for older people who have to stay at home because they've got severe health risks like chronic obstructive pulmonary disease, or because they're a higher risk population, to be able to phone in supermarket orders and get them delivered? Because, again, particularly I know that in my constituencies, there is a significant number of older people who simply do not have access to that IT equipment to be able to put an order out to one of our favourite supermarkets.
I've got a specific question that I'd like to ask about the workforce. In a previous statement, you said that you planned to employ volunteers and staff who've recently left the NHS. So, they're going to be current. Could you confirm that locum doctors will be offered contracts that will cover them and their families in the event of serious ill-health or even death if they die in service because of this? Will you be looking at that going forward? Because it's one thing to ask a retired GP or a retired consultant perhaps or nurse to come back in and cover a shift and they've recently retired, we can get them a quick fitness to practice certificate—I understand all of that and that will, no doubt, be taking place—but we also need to cover them if the worst happens. So, can you just confirm that perhaps this will be an area that you would look at?
You've also talked about the opportunity of video consultations, which actually I think is a very important step forward, but, again, are you giving some thoughtto what plans might be in place for the areas where video connectivity, because of our IT infrastructure, simply isn't available, and I could give you quite a few notspots in my constituency where that really wouldn't happen?
There are lots of questions to ask on coronavirus, and I simply am not going to take up lots more of your time. My last question would be that, of course, South Korea believe that they've passed the peak, and that they're now coming down the other side; they're quietly confident. They've been very effective in how they've dealt with it. They have a different social structure, and a different culture, but one of the things that they did use was they used social media to help to track a coronavirus-identified patient. Obviously, I don't know—I assume that they had permission—but to track where they'd been, so that they could then try to use that kind of technology to find out who else might be at risk. Could you just tell us whether or not you've got any thoughts in the weeks ahead? As I say, not now—I appreciate it's not in place at this moment—but we all recognise that this virus is going to expand. The situation will get worse and the things I've mentioned are just things that we could do to help perhaps to chase down or to mitigate, and I just wondered if you'd been looking at somewhere like South Korea, who think they're through the worst of it, to learn what best practice we can to help us contain the situation, or at least manage the situation, in our country.

Vaughan Gething AC: Thank you for the series of comments and questions. Your first point about the new team that I've referred to within the Government: the fact that I've instructed the chief exec of NHS Wales to set this up, there should be more than enough stripes, to use your terminology, within the NHS to make sure that people respond with an appropriate level of seniority. It's about co-ordinating the work within the Government as well as the interface together with the health service. And on your point about isolation measures, going back to some of the points the First Minister made in questions as well, this is actually about how we ought to flex up our capacity to meet people, but also we're going to need to treat people in different ways. People who would normally come in to a hospital setting for their care—we may need to treat teach more and more of those people in their own home in a different way. So, actually, I don't think we should get fixated on the number of beds we currently have but actually about our capacity across our whole system to be able to treat more people, and what that means, and the different treatment choices we'll need to make, and what we'll actually then need to do, for example, together with both regulators and royal colleges as well.
When it comes to the personal protective equipment for general practice and pharmacy, and what that might mean for other people who have direct contact with, in particular, at-risk groups of people—that goes into part of the conversation we're having, not just with the staff in domiciliary and residential care, but also one of your later points about the work with supermarkets. I've already instructed officials to have those conversations about providing goods to people who may be in their own homes for a longer period of time, but it's also about the work the local government in particular will need to do, both in planning for a change in the nature of the way in which services will be delivered, about the way they deliver services in people's homes already, either because they're directly providing that care, or they're commissioning care, and the way in which they'll need to plan for a different way to deliver services—again, potentially with fewer staff at some point, but also potentially with an increase in demand coming through their doors too.
On your point about IT access, the steps that we've taken to provide a consistent piece of software across the system is a real step forward, but that doesn't mean that it has universal coverage, because you're right to point out that there are some people who either don't have IT equipment or don't have access effectively to it for a number of reasons. So, there are also things—[Inaudible.]—other people as well. And again, that's a challenge that not just the health service faces, but a range of other public services too.
And on your point about access to the symptom checker, Public Health Wales have already provided a range of advice posters that talk about symptoms in there, so it's not just an online forum. I've seen in my recent trip to north Wales what that means, and at Cardiff Airport—where they're visible; I think they're very clear—but also a range of businesses have used exactly the same information posters. And that goes back to the points being made before about clear and consistent advice in using advice from a trusted source of information so I'm really encouraged by the way in which that very simple and clear advice is being used in a wide range of areas.
And I'm happy to reiterate the point about 111. It is an all-Wales service—an all-Wales service for coronavirus. So, if people are concerned, they can ring that number from any part of Wales to be provided with advice and guidance.
On the report about indemnity for people who are locums, I'm happy to explore that area further to see about whether we do need to change any of our current arrangements to make sure we have the right numbers of staff in the right place to provide care and treatment and also give people the assurance they may be looking for.
And on your final point about international learning, not just from South Korea, but from more broadly across the world—that was part of your discussion at COBRA this week. It's part of the discussions I've had on a regular basis with the chief medical officer, because what appears to be slightly different advice is being given in different parts of the world, but it's also learning from people in different stages of an outbreak as well. Actually, the work of the World Health Organization will be really important in this. But we certainly want to be linked in to the best possible advice, not just across the UK, but internationally too, about lessons we can learn—and we're slightly behind where other parts of the world are with this outbreak—to try and make sure we make better choices here, or we better understand the choices we are inevitably going to be faced with. So, yes, it's important in the here an now. It will also be important afterwards. So, once we're after the peak of the coronavirus outbreak in the UK and across the globe, it's how we learn from what's happened and understand what we'll better need to do in the future.

The Deputy Presiding Officer (Ann Jones) took the Chair.

Rhun ap Iorwerth AC: May I thank the Minister for the statement and thank him for the briefings provided both to me and to other party spokespeople at this time?
May I just tell you a story about a doctor who contacted my office to complain about the 111 line, because she dealt with a patient who'd had to pay £10 to call the 0845 number because 111 didn't work and the patient wasn't able to use a landline at that particular time? This particular patient and her husband had travelled back from Italy recently, where they'd been on holiday with friends. Having returned, those friends who lived in England were tested and tested negative for COVID-19. The patients in Wales then got a headache and a cold and phoned the 0845 number, but they were told that they were unlikely to be at risk and that they didn't need to be tested. But because their friends in Essex had been tested, they felt that they should take further steps themselves and they decided to drive to Ysbyty Gwynedd. They spoke to a nurse there who triaged them over the phone. The doctor then put an apron and gloves on and went out of the car to ensure that tests and diagnosis could be provided, and what I've heard is that there was a lack of understanding even among hospital staff in terms of out-of-hours medical care in terms of what exactly to do in cases such as this. This is a cause of concern, of course, if the front-line staff themselves don't feel that they have the appropriate advice to provide to people, or appropriate clothing to protect themselves, although I do note, and am thankful, from the statement that GP surgeries are to be provided with appropriate clothing now.
There are a number of questions arising from this for me. First of all, if people can't contact 111 for some reason, or perhaps can't afford to phone the 0845 number, is there a risk that we are missing some cases? What steps will be taken in order to strengthen that 111 provision further?
If staff in hospitals feel that they don't have the necessary equipment to safeguard themselves, is there an expectation that they should be provided with that clothing and equipment? Also, what steps are being taken to strengthen the provision in hospitals for those people who act contrary to the advice provided and go to hospital in any case? Because people are going to do that, unfortunately. I hope there'll be few cases, but it will happen. So, what will be done to ensure that hospitals are ready for that?
If I could also make an appeal for an update on the more intensive care capacity. It is crucial, I think, that we at this point in time do ensure that that capacity is in place for more intensive care beds to be provided in hospitals. I do think that it's fair to say that our experience from other nations in looking at what happens elsewhere tells us that the kind of care provided to people at that point where their illness becomes serious, whether the care is appropriate for them and good enough for them at that point, can make the difference as to whether those individuals survive this virus or not. So, what's being done now to ensure that that capacity is built for the needs that could arise over the next few weeks and months in terms of intensive care in hospitals?

Vaughan Gething AC: I want to thank you for the comments and questions. I think your story of real experience in the recent past is important for all of us. On 0845, the old 0845 number, that is a cost that phone providers themselves charge and we're not in control of that. That's really frustrating, but we've taken the step to have an all-Wales 111 service so that it's a consistent number, so that we're not asking people in different parts of Wales to check which number they should use. I think it's really important, those points about clarity and consistency in the message that we have.
I'm really clear that if they need more resources, then we'll find more resources to give them more capacity to deal with people. There is something then about our whole NHS system understanding what to do, both about whether they need to use protective clothing or equipment, but also to make sure that people do themselves understand, in a simple and a clear way, how they should behave with members of the public. I think your point about the fact that they drove to a hospital site when that's exactly what we're asking people not to do, and our challenge about reinforcing for people to please follow the advice to keep them and other people safe—it's about keeping them safe, their family, their loved ones, but also people they may never have met. This is a really serious position.
The choices that we may well be faced with making will be choices that are imperfect, in the sense that we may be making choices about putting off activity within the health service to prioritise the most serious activity; we may be asking people to deliver treatment in a way that isn't what you'd expect to deliver in the here and now today, because of the capacity and because of the demand that we may see coming through our doors. The situation in Italy should tell us something about the choices we may face.
Italy is not a developing world country, they have a good developed world health system, and yet their healthcare system is over-topped at present. They've over-topped all of their intensive care capacity, including having scaled that up by redeploying their staff, and they're having to make some of the choices that the First Minister described as well. They're talking about treating people in hospitals not in the sort of position that they might otherwise have wanted those people to be in, in an intensive care bed, but they may not have those beds because they're full; they're talking about people who may need ventilation, they don't have that, they're thinking about alternatives. As I've said several times, we may be treating people in their own homes when today we would definitely be saying, 'That person should be in a hospital, in a bed with a certain level of escalation.' These are not trivial choices we are actively contemplating having to make.
Even if we flex all of our capacity, if we switch off other areas of activity, if we redeploy all of our staff, it is still possible that if we don't take steps, if we don't take effective measures, we could be over-topped. It is also possible that, doing everything humanly possible, a new condition that we don't have a vaccine for, we don't have effective anti-viral treatment for—it is possible when you look at the reasonable worst-case scenario that a range of our services could be over-topped. That's the challenge we're facing, so the seriousness of all the choices we make are real. As I say, the scale of what is happening in Italy now should reinforce that, not just the rise in the death toll numbers, but also the numbers of people that are seriously unwell at present today in Italy and they're having to care for.
So, I'll be happy to deal with all of those points as we come through and have to make choices, both about choices that we are making, about change in the way the health service works, but also about choices that we are saying we don't need to make. Again, we're asking the public to follow the advice that we're giving from trusted sources, the Government the national health service, and to make sure that we do follow that advice and not some of the alternative advice that exists from alternative commentators that are being giving a platform on social media and the broadcast news. I saw an interview Rory Stewart did—a former Cabinet Minister—and he was suggesting that the Government should ignore the scientific advice and take action early, in advance of what the science tells us. That is entirely the wrong thing to do. I was very disappointed because it's highly irresponsible, so this Government will make choices even if they seem counterintuitive. I re-provide the reassurance that we are definitely definitely listening to the four chief medical officers across the UK and we are definitely looking to the very best scientific advice we have to base our decisions upon.

Alun Davies AC: I think the thoughts of all of us in this Chamber and elsewhere are with all those people who are currently suffering from this virus and those who believe that they might be but are maybe awaiting diagnosis, as well the families of those who have already died. I think this is one of the most terrifying threats to us as people and to our society that I've certainly seen in my lifetime. I can remember on no other occasion how a disease like this has spread across the globe and has infected so many people and caused so much suffering in societies across the whole of this world.
I'm glad that the Welsh Government is listening to experts, and I'm glad that the Welsh Government is following the advice that our scientists and doctors are providing to us. It is absolutely essential that, in responding to this crisis, we follow the best advice and scientific analysis that we have available to us. I'm also very pleased to see that the Welsh Government is working closely with the other Governments across the United Kingdom to ensure that we do have the sort of holistic response that we require. I would say that I believe that the Welsh Government is the only administration, if you like, in this country capable of co-ordinating all of the responses required across all of our public services and across all of the different services that we will require as a country to come through this virus. I hope that the Minister—he hasn't mentioned this in his initial response, but I trust the Minister is working closely with his colleague sitting next to him, the Minister, I think, who is responsible for civil contingencies, and perhaps he would explain the structures that the Welsh Government are putting in place to ensure that we have the full, civil contingency response that we will require.
But I think the thoughts of many of us are with those people working in the national health service who will bear the brunt of this virus and the human consequences of this. Many of us have been seeing and hearing and reading of the impact that this is having on the medical service and the health service in Italy and the impact it is having on the people working within the health service in Italy who have to take life and death decisions, who are working long hours under extraordinary pressures to deal with the human impact of the virus. In my experience, one of the most difficult civil contingencies that we've dealt with across the United Kingdom was that in Salisbury, and the poisoning that took place there some years ago. One of the lessons learned there was the burnout and the impact that responding to these emergencies has on people over an extended period of time. Clearly, the incident in Salisbury was an isolated, single incident; this is something that is going to be happening in every community across the whole of this country over an extended period of time.
I hope that—. And perhaps the Minister will explain to us the sort of measures that the Government is putting in place to protect national health service workers and to ensure that we're able to support people working in the national health service to ensure that they have the support that they need, but to also look outside of the national health service to ensure that we have the care available for vulnerable people, people who may be living alone, people who might be living with life-limiting conditions at present, to ensure that they are kept safely in their homes and in their communities, but also support for small businesses as well. This is extending beyond, perhaps, this Minister's responsibilities, but it is easier for a multinational to withstand this than a corner shop, and we need to ensure that the small businesses of this country are protected as well. That takes us to ensuring that our public services have the support that they require as well. Local government, amongst others, amongst education and elsewhere, will be on the front line in dealing with much of the impact of this virus, and we need to ensure that our public services have the support and the co-ordination that they also require.
Finally, Minister, in your statement, you outlined four-country legislation that is going to be passed by Westminster to provide Ministers here with the powers that you require in order to deal with this, and I very much welcome that, but can you assure us that the powers that you will be taking will be subject to sunset clauses so that these powers do not remain on the statute book at the end of this emergency, so that we don't, almost by accident, grant the Government enduring powers over our lives outside of this emergency?

Vaughan Gething AC: Thank you for the series of questions. I think I'll start with some of your early points—I'll try to take them in order. I don't always agree with Matt Hancock, and I certainly don't always agree with Boris Johnson, but, during our COBRA calls, there has been a genuinely serious and grown-up attempt to go through issues and to reach agreement on finding the best way through. In fact, the Prime Minister has said, and I agree with him on this, that the greatest risk of panic and the wrong response is often politically driven demands in contradiction of the science and the evidence. So, our response is based on the science and on the evidence.
In terms of the work we're doing across Government, I have already met with Julie James at the start of the now very regular COBRA meetings. We've had a conversation, and I've met with her lead official who co-ordinates much of the civil contingencies work. We've also formed, as the First Minister said, a core ministerial group—if you like, a COBRA Cymru group of Ministers—and we're meeting each week. I chaired the first meeting of that group last week. We're meeting again tomorrow, so there'll be regular conversations between Ministers so that Ministers are informed of different choices that are being made, but, equally, so Ministers can co-ordinate choices within their own portfolio areas, because every group of stakeholders working to every group of Ministers will be affected by this somewhere along the line, as you say.
And it's not only the choices that we make there, because your specific choices around small businesses, I think, are really important. Because there is a range of measures that Welsh Government could take, but, actually, on many more of those, there's action that the UK Government will need to take on a whole-UK basis. I hope that the budget tomorrow sets some of those out. That's why the finance Minister was in London at the start of the day to have that conversation. That, again, came from a previous COBRA meeting, where there was agreement that that meeting should take place with finance Ministers in all of the devolved national Governments.
We'll then need to see what measures are taken tomorrow, but as the outbreak develops to make sure there's a fleet-of-foot response from the Government across the UK as well. Obviously, the economy Minister has already asked his officials to look at the measures that we could take here to support small businesses in particular. That, potentially, could be as a consequence of the public health advice that we give. If we ask people to stay at home—if we ask more people to stay at home—that could have an impact on either the custom that goes out, but also people going to work themselves. A small business say with five employees—well, if two of those people are asked to stay at home, that can make a really big difference to the running of that business.
Your point about the human impact of this, I think, is also really important as well, because we're really talking with the Royal Colleges and regulators about the potential impacts of making different choices and holding people to standards at the time. But there is a human impact in, if people are seeing large numbers of very sick people, not making choices that they would otherwise make, and not feeling they're able to be in control as they would normally expect to be in delivering health and care, and that's something that we discovered both at the partnership forum, the NHS partnership forum, between the Government, the employers and trade unions on Thursday in north Wales, when I attended.
Again, we're trying to work through some consistent advice, so we don't see a wildly varying approach being taken between different NHS organisations here in Wales. There is a broader point there about public services too, because it won't just be NHS workers who will find themselves in a very difficult position, as you point out. That's a matter that I went through with social care cabinet colleagues from local government yesterday. So, across all parties, they recognise that they need to go and look at the way in which they run their services, and, obviously, the leaders of every local government organisation will need to think about that too.
I'm pleased you made the point about social isolation—if we're asking people to stay at home, what that means, regardless of the age profile. Given that we understand that social isolation and loneliness are a real challenge for lots of people, if we're then asking more of those people to not have that social interaction, again there's a choice for the Government, for the health service, but also for local government, about what form of social interaction can those people have to make sure that they're still being checked up on and not ignored, if we're asking them to avoid what would otherwise be normal social contact that helps people to stay well and healthy. So, it isn't a simple measure of, 'Take one step and that will keep everyone safe.'
The final point I'd make is just to give you some reassurance about the emergency powers Bill. All Ministers are cognisant of the fact that, in asking the legislatures across the UK to trust Ministers with powers, there should be some safeguards, and that definitely includes sunset clauses. So, any legislation, you'd expect to see sunset clauses in that about not just how powers are enacted but how powers get switched off again as well, because I recognise completely the point that the Member makes.

Caroline Jones AC: Thank you for your latest update, Minister, and I welcome the measures the Welsh Government, Public Health Wales and our excellent NHS staff are taking to protect us from the spread of the SARS COV-2 virus. Some of the measures, such as the new software to enable video consultations, will enhance our health service beyond this outbreak, and we must capitalise on this service, which, in this instance, replaces face-to-face contact and is absolutely necessary at this point.
At this point, it is important to reiterate to the public that we must all try to be as not panicked as possible, and while it is right that we prepare for all eventualities, there is no need for the public to change the way they go about their day-to-day activities, apart from taking precautions against respiratory illnesses, such as regular hand washing and never touching your face with unwashed hands. But this guidance should be normal practice, and we must note that influenza kills more than 0.5 billion people a year, so it's important to keep that in perspective.
It is also important to check the information that is readily available to the public and ensure that it is updated, and also to ensure that our most vulnerable in society have access to all of this information and our hard-to-reach communities are also made easier, so that they can interact regarding information on this virus.
So far, we have six people infected with SARS COV-2, and that's 0.0001 per cent of the population of Wales: six people out of 3.2 million. So, it is reassuring to note that, across the UK, there have been around 320 cases out of a total population of 70 million. It is important also to note that we keep our perspective, prepare but do not overreact, and the biggest threat in any viral outbreak is public panic. Rumour is currently our biggest enemy and social media is rife with fake cases and fake cures, and everything from drinking bleach to snorting cocaine. It has led to panic buying, resulting in short-term shortages as the supermarkets restock, further adding to the rumour mill.
So, Minister, what discussions have you had with the UK Government and have had with the social media platforms about the best way of tackling the spread of misinformation, and how to promote information from trusted sources such as Public Health Wales?I would once again like to thank you for the measured approach the Welsh Government is taking in preparing for the impacts of a COVID-19 outbreak.
I have just one or two questions relating to preparations here in Wales. Minister, last year the Welsh Government made preparations for a 'no deal' Brexit by securing warehouse space and stockpiling certain medicines. Minister, what role, if any, will those measures play in preparing for a wider scale outbreak?
And, finally, Minister, there have been reports that the SARS COV-2 virus will impact the availability of pharmaceutical ingredients coming out of India. This supply chain is vital to the generic medicines trade, so what discussions have you had with the pharmaceutical industry about the best ways to mitigate any threats this virus will have upon the supply of pharmaceutical products? Thank you.

Vaughan Gething AC: Thank you for the comments and questions. On your questions, there is already an NHS team that is taking—. There was an announcement—you might have seen publicity on it yesterday—in terms of some of the points about search engines and which terms are going to come to the top of those outcomes and results to make sure they're from trusted sources, but also in terms of trying to rebut on social media some of the more lively conspiracy theories but the range of information and misinformation that is in the public realm, and that is a real problem for us.
Our 'no deal' preparations will actually stand us in relatively good stead, both in terms of stakeholders who have a range of measures to deal with interruptions in their supply, but also the warehouse you mentioned.We actually purchased that, and so we do have some additional resilience. But the challenge comes, like you said in your question, about generic medication. We need to be upfront about what we can do, but also, if there are steps that we can't take, to be clear that we can't take those steps as well. So, we're looking for intelligence from the pharmaceutical industry itself, which manufactures and imports those medications, to understand if there are risks to supply and if there are alternatives or not.
And I think the final point I'd make is that, with the low-level flu that is relatively circulating here, with the low level of people who have coronavirus in Wales today, we expect that over the coming days more people will be diagnosed with coronavirus. So, the relatively low number of cases today should not be taken as a sign that this is nothing to worry about and there's no need to do anything about it. This is a real concern. There is already community transmission in some parts of England; that will take hold in other parts of the country.
So, we have to absolutely understand we will have more coronavirus cases in Wales; there will be people who will become unwell. What we can't anticipate exactly is how many people that will be and the impact that will have upon our services. This is not like another mild flu season taking place out of winter. We don't have a vaccine for coronavirus, COVID-19; we don't have effective antiviral treatment. So, if this circulates widely, it will have a real impact on the health of very many people who are already vulnerable. That is why we're taking it so seriously; that is why we're taking extraordinary steps; that is why there is so much co-operation between four Governments who would otherwise have plenty to disagree about at the top of their agenda.

Thank you very much, Minister.
Item 6: the Regulation and Inspection of Social Care (Wales) Act 2016 and Regulated Services (Miscellaneous Amendments) Regulations 2020, and item 7: the Social Care (Wales) (Specification and Social Care Workers) (Registration) (Amendment) Regulations 2020. I propose, unless any Member objects, in accordance with Standing Order 12.24, that the following two motions are grouped for debate.

6. & 7. The Regulation and Inspection of Social Care (Wales) Act 2016 and Regulated Services (Miscellaneous Amendments) Regulations 2020 and the Social Care (Wales) (Specification and Social Care Workers) (Registration) (Amendment) Regulations 2020

Therefore, I call on the Deputy Minister for Health and Social Services to move the motions—Julie Morgan.

Motion NDM7292 Rebecca Evans
To propose that the National Assembly for Wales; in accordance with Standing Order 27.5:
1. Approves that the draft The Regulation and Inspection of Social Care (Wales) Act 2016 and Regulated Services (Miscellaneous Amendments) Regulations 2020 is made in accordance with the draft laid in the Table Office on 11 February 2020.

Motion NDM7293 Rebecca Evans
To propose that the National Assembly for Wales; in accordance with Standing Order 27.5:
1. Approves that the draft The Social Care Wales (Specification of Social Care Workers) (Registration) (Amendment) Regulations 2020 is made in accordance with the draft laid in the Table Office on 11 February 2020.

Motions moved.

Julie Morgan AC: Thank you, Deputy Presiding Officer, and I move the motions. The two statutory instruments before you today amend the Regulation and Inspection of Social Care (Wales) Act 2016, and there a number of regulations that flow from that Act. It's the intention that these amended regulations come into force on 1 April. Both sets of regulations are an important step towards realising our goal to professionalise the social care workforce, to continue to raise the quality of care, and to ensure that workers get the support and recognition that they do deserve.
The miscellaneous amendments regulations deliver several key changes. First, they amend the regulations about service registration that enable the service regulator, Care Inspectorate Wales, to request additional information from individuals who make up the governing body of an organisation registering to become a service provider. This includes, for example, the individuals on the board of directors or trustees. The service regulator is then able to take this information into account when assessing the fitness of the service provider.
Secondly, the regulations also provide additional clarity about the notifications that providers must make to the service regulator. They require that providers make a notification when there is any change to the key decision makers of the organisation, regardless of its legal entity.
Thirdly, they also require providers of domiciliary support services, care homes for children, and secure accommodation services to employ only those individuals who are registered with the workforce regulator, Social Care Wales, within six months of commencing employment. This will also apply to anyone engaged under a contract with these service providers, including agency workers.
The social care workers registration regulations enable Social Care Wales to open the register to individuals working in care homes wholly or mainly for adults, and in residential family centre services, who can join the register voluntarily from April 2020. This provides these workers with a two-year lead-in period, during which the workforce regulator, care workers and their employers can work together to prepare for mandatory registration, which we plan to introduce in 2022.
Registration recognises the professional responsibility of care workers who provide absolutely vital care and support to people with increasingly complex needs. It'll help toensure workers are suitably qualified and trained for the work they do. It will provide those workers with access to additional support and resources from Social Care Wales. Registration also provides additional safeguards to the public so that, should an incident occur, workers can be held to account by the workforce regulator. Thank you.

Thank you. I have no speakers. We have to take the votes separately. Therefore, the proposal is to agree the motion under item 6. Does any Member object? No, thank you. Therefore, in accordance with Standing Order 12.36, the motion is agreed.

Motion agreed in accordance with Standing Order 12.36.

And, again, the same, the proposal is to agree the motion under item 7. Does any Member object? No. Therefore, again, the motion under item 7 is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.

8. Debate: The Police Settlement 2020-21

We nowmove on to item 8, which is a debate on the police settlement of 2020-21, and I call on the Minister for Housing and Local Government to move the motion—Julie James.

Motion NDM7291 Rebecca Evans
To propose that the National Assembly for Wales, under Section 84H of the Local Government Finance Act 1988, approves the Local Government Finance Report (No. 2) 2020-21 (Final Settlement—Police and Crime Commissioners), which was laid in the Table Office on 23 January 2020.

Motion moved.

Julie James AC: Thank you, Deputy Presiding Officer. I am today presenting to the Senedd for its approval details of the Welsh Government's contribution to the core revenue funding for the four police and crime commissioners, or PCCs, in Wales for 2020-21.
Before I do so, Presiding Officer, particularly given the recent events, I'd like to record my gratitude to all of the Welsh emergency services for their resilience and fortitude, and I'm sure these comments will be echoed in this Chamber and across the residents of Wales. Those who serve in our police forces across Wales not only keep our communities safe, they maintain the highest standards of duty, dedication and, at times, bravery. This was demonstrated most recently when they worked with others to protect and save some of our communities from the recent storms. I recognise the importance of the Welsh police forces and their vital role in protecting and serving our communities here. The police service in Wales is a positive example of how devolved and non-devolved services can work effectively together.
Members will be aware that the core funding for the police in Wales is delivered through a three-way arrangement involving the Home Office, the Welsh Government and council tax. As policing policy and operational matters and non-devolved, the overall funding picture is determined and driven by the Home Office. The established approach to setting and distributing the Welsh Government component has, therefore, been based on a principle of ensuring consistency and fairness across England and Wales.
I would also like to thank PCCs for their patience this year. Due to the now, sadly, normalised chaos and uncertainty from Westminster, the PCCs did not have a provisional police settlement this year. With delay after delay to the UK budget, due to the general election, exiting the European Union, and now a new Chancellor to add to the ongoing uncertainty, this year's PCCs have had to notify their police and crime panels of the proposed change in precept fewer than two weeks after being informed of their funding allocations. Still the UK Government has not published its 2020-21 budget, leading to continuing uncertainty for our public services, businesses and individuals.
As outlined in the final police settlement announcement on 22 January, the total unhypothecated revenue support for the police service in Wales for 2020-21 amounts to £384 million. The Welsh Government's contribution to this amount, through revenue support grant and redistributed non-domestic rates, is £143.4 million—and it is this funding you are being asked to approve today.
As in previous years, the Home Office has decided to overlay its needs-based formula with a floor mechanism. This means that, for 2020-21, police and crime commissioners across England and Wales will all receive an increase of funding of 7.5 per cent when compared with 2019-20. The Home Office will provide a top-up grant totalling £14.4 million to ensure both Dyfed-Powys Police and North Wales Police meet the floor level.
The Home Office advises that this settlement includes the funding to recruit an additional 6,000 police officers shared amongst the 43 forces in England and Wales. The Welsh Government is determined to strengthen the economy and create employment opportunities across the country. I welcome the opportunity for people across Wales to consider a career in the police forces. The Prime Minister has committed to a target of 20,000 new officers over the next three years. However, for this to happen, I urge the UK Government to pledge to provide the associated funding to our police and crime commissioners for future years.
As in 2019-20, the Home Office will continue to provide a specific grant to PCCs in 2020-21 to fund the additional pressure as a result of the UK Government's changes to the pension contribution rates. The Home Office has kept the grant value at £143 million in 2020-21, with £7.3 million of this allocated to PCCsin Wales. PCCs also have the ability to raise additional funding through their council tax precept. The UK Government has set the upper precept limit for PCCs in England to £10 in 2020-21, estimating this will raise an additional £250 million. Unlike the limits that apply in England, Welsh police and crime commissioners have the freedom to make their own decisions about council tax increases. Setting the precept is a key part of the police and crime commissioner's role, which demonstrates accountability to the local electorate.
We appreciate that difficult decisions are necessary in developing plans for the coming years with only a one-year budget. The Welsh Government is committed to working with PCCs and chief constables to ensure funding challenges are managed in ways that minimise the impact on community safety in Wales. As part of this, the Welsh Government in its 2020-21 budget has continued to fund the 500 community support officers recruited under the previous programme for government commitment. The Welsh Government has maintained the same level of funding for the delivery of this commitment as in 2019-20, with £16.8 million agreed in the budget for next year. One of the main drivers behind this project was to add visible police presence on our streets at a time when the UK Government is cutting back on police funding. The full complement of officers has been deployed since October 2013, and they are making a positive contribution to public safety across Wales. They will continue to work with local communities and partners to improve outcomes for those affected by crime and anti-social behaviour.
Returning to the purpose of today's debate, the motion is to agree the local government finance report for police and crime commissioners that has been laid before the Assembly. If approved, this will allow the commissioners to confirm their budgets for the next financial year. I therefore ask Assembly Members to support this motion today. Diolch.

Mark Isherwood AC: Labour's March 2010 UK budget statement revised down the growth forecast, reduced borrowing, and stated that the scale of the deficit meant the UK didn't have enough money. In consequence, it also announced £545 million of cuts to the police to be made by 2014. Since 2015, UK Government has raised its contribution to overall police funding in line with inflation, including specific areas such as cyber-crime, counter-terrorism, and tackling child sexual exploitation. The UK Government has now announced a £1.12 billion increase in 2020-21, taking the total settlement for policing to £15.2 billion. This includes £700 million for 6,000 additional officers by the end of March 2021. As the Minister indicated, the UK Government aims to recruit 20,000 total new officers across the UK.
The majority of funding for police and crime commissioners comes directly from general Government grants, as we heard—London and Cardiff—and around a third comes from the council tax police precept, which is increasing this year by 6.82 per cent, £273 per annum, in Gwent; 5.9 per cent, £273 per annum, in south Wales; 4.83 per cent, £261 per annum, in Dyfed Powys; and 4.5 per cent, £291 per annum, in north Wales. Although the South Wales Police Federation stated in 2016 that the council tax precept gap with the other Welsh forces had now been closed, it's apparent that, although north Wales has the lowest percentage increase, council tax payers there are still paying more than the Welsh regions facing the biggest percentage increases.
Following a long-term reduction, levels of crime have remained broadly stable in recent years. While in the latest year there's been no change in overall levels of crime, this hides variations seen in individual crime types. Excepting fraud, the latest figures from the crime survey for England and Wales show all main crime types showed no change. As the Office for National Statistics has said:
'Although the number of offences involving a knife has continued to increase, there is a mixed picture across police forces and overall levels of violence remain steady'.
The budget increases in north Wales will fund 10 more officers for the major crime unit, 20 new auxiliary police staff, 16 additional response officers, and five more community safety officers, including three for the rural crime team. This weekend, the Home Secretary and Secretary of State for Wales joined the North Wales Police to see how they're tackling the county lines drug problem in the region. As well as announcing their plans to recruit new police officers, the Home Office also confirmed that they'll be providing North Wales Police with nearly £150,000 to invest in 167 new taser devices, part of £576,000 across the four Wales police forces. This comes as part of a UK-wide uplift that will see £6.5 million divided between 41 police forces. Speaking in north Wales, the Home Secretary said:
'I'm committed to providing forces across Wales with the powers, resources and tools they need to keep themselves and the public safe.'
She also said that she was consulting on a UK Government's police covenant, called for by the police federation, recognising police officers' service and sacrifice, and enshrining their rights in law. Other steps recently taken by the Home Office were highlighted, including expanding stop-and-search powers, and plans to increase the maximum sentence for assaulting emergency service workers.
In January, I visited Titan, the North West Regional Organised Crime Unit, to receive a useful presentation on their role and their capabilities to prevent and protect, dealing with matters such as serious and organised crime, the control of drugs, county lines, economic crime and cyber crime. Titan was established in 2009 as a collaboration between the six police forces in north Wales, Cheshire, Merseyside, Greater Manchester, Lancashire and Cumbria, to tackle serious organised crime that crosses county borders in the region. They told me that an estimated 95 per cent or more of crime in north Wales operates on a cross-border, east-west basis, and almost none on an all-Wales basis, and the north Wales police representative present also confirmed that all their north Wales emergency planning is done with their partner forces in north-west England, and they have no significant operations working with the other police forces in Wales.
Labour and Plaid Cymru, of course, propose the devolution and Cardiff control of justice and policing, while a Welsh Conservative Government would instead work with the UK Government to deliver policing and offender management services in Wales that reflect our devolved responsibilities. We would back the law-abiding, hardworking silent majority; not give a vote to prisoners convicted of sexual and racist crimes, as Labour and Plaid Cymru propose. Diolch yn fawr.

Leanne Wood AC: The British Government seem to have recognised the damage that they've done with 10 years of cuts to policing. However, one year, or even two budget increases will go nowhere near far enough to reverse the damage that's been done. So, this increase in funding must be the first step in addressing the chronic lack of funding that still exists. To address the chronic problems that Welsh police forces face, the funding formula, we believe, must be reformed.
The current formula discriminates against council tax payers in Wales. The formula doesn't adapt to urban and rural needs, and the potential for recruitment from the apprenticeship levy is not being utilised. The plans to fund 20,000 police officers doesn't cover what has been lost since 2010. Plaid Cymru therefore wants to see a funding formula for Welsh police forces that is based on population and need, rather than the UK Government's flawed formula. The Welsh Government also has a part to play to ensure that funding to tackle the root causes of crime is addressed. Youth services in Wales have had their funding cut by 38 per cent, which equates to a loss of £19 million since 2010, inevitably making police officers' work much more difficult. Proper and adequate funding of other services, like, for example, mental health support, would also be very helpful to the police.
Despite their various constraints, Plaid Cymru's police and crime commissioners have launched a three-year early intervention fund worth £800,000 to address adverse childhood experiences, as part of an attempt to tackle the underlying causes of crime. The National Farmers' Union have used north Wales as a case study for tackling rural crime. Dyfed Powys Police have created schemes such as Farmwatch to provide crime prevention advice, and they've launched Checkpoint Cymru, which diverts low-level offenders away from the criminal justice system. These principles can be applied elsewhere. Imagine what those police and crime commissioners could do with secure funding that isn't tied to Westminster's agenda. Diolch.

Mick Antoniw AC: Thank you, Deputy Llywydd. When Mark Isherwood was making his speech, it reminded me a little bit of some of those Soviet economic reports you used to get—the last five-year plan was absolutely fantastic, but not as good as the next five-year plan. I'm afraid there's a real danger when you start being so selective in terms of the figures that you actually use. And I think we need to look at where we are. When we debated this last time, the state of play was an 18 per cent increase in violent crime,a 14 per cent increase in knife crime in south Wales, a 25 per cent increase in Wales, 84,000 crimes unsolved, and, since 2010, we now have—well, we then had 682 fewer police officers. Now, those figures go together. What is the situation now? The situation now is that we actually have around 762 fewer police officers than we had in 2010. Crime and serious violent crime is increasing. We've become very dependent on the additional 500 police and community support officers that are funded by Welsh Government out of our own funds—not money that should be allocated by UK Government for that. And in fact, when we look at the PCSO figures across the UK, we've actually lost in the region of 6,680 police and community support officers across the UK, with, obviously, the consequential effect within Wales, which is why the Welsh funding on this is so absolutely important.
And Leanne is absolutely right to raise the issue of those areas of funding for the work that the police do that is not just about catching criminals, but is engaging within society, whether it be mental health, drug and alcohol funding, rehabilitation, and so on—all those things that are partnership, which have an impact on policing and have an impact on the social stability of our society and the well-being of our communities. And the fact of the matter is that, with the fact that we have a modest increase in real terms this year, it doesn't get over the fact that, in actual fact, over the next five years, we actually need—if we're going to restore the Tory cuts since 2010—to recruit 53,000 police officers, when you take into account the retirements. Now, this is the same—. Mark is guilty of the same manipulation of figures that we had over nurse numbers, and so on—that when you're actually taking in recruitments, and the need for ongoing recruitment, the picture presented is very much different.
Now, for anyone who speaks to the Police Federation, to police and community support officers and to the police and crime commissioners, you get a number of very important points coming to the fore, one of which is that, even with the recruitment of those police numbers—if we were able to achieve that—what we have actually lost, which will take a decade to replace, are the skills and the quality of policing that has been achieved. Because we have been losing some of the most well-qualified and experienced police officers. And the other point they make is that not only will it take a long time to repair the Tory damage to policing, at the moment, not much has changed. And that's the best you can say about the Tory record on policing—not much has changed, the damage they wrought since 2010 is still there, and it will take decades to recover. The modest settlement we have is only a very, very small start, scratching the surface.

Alun Davies AC: I'd like to start by echoing the Minister's thanks to police officers across the country for the work they do in keeping us safe in our communities. They've been under enormous pressures over the last few weeks and months, and I think all of us would want to join together and recognise how they've responded to those pressures. And they've done so having suffered year-on-year cuts over the last decade. Austerity has not been kind to our police forces. In fact, the UK Government—the Home Office—is spending less in cash terms this year than they were spending a decade ago. And whilst we hear from the Tories that they want to put more resources into the police, what I would say to them is, 'Why don't you start with where you started back in 2010, when you started attacking the police force?' And we need to ensure that we do have the resources in place to ensure that our police are able to keep us safe.
But not only have the Tories cut back on the total amount of spending that the police have available to them, they've also transferred funding from the police. Mark Isherwood said that a third of funding comes from the council tax. In fact, in 2010-11, 33 per cent—he was right, 33 per cent—of funding came from council tax. Today, this year, that figure is 47 per cent—it's nearly half funded through council tax. And the Home Office funding,which was 40 per cent in 2010-11, is 32 per cent today. So, there's been a real transfer of responsibility for funding the police from the Home Office, from the United Kingdom Government to Wales, to the Welsh Government and to council tax payers. The vast majority of funding from the police today is raised here in Wales. Nearly 70 per cent of all police funding in Wales today comes from sources within Wales, and that means that we also need the structures available to us, not simply the budgets, but the structures as well.
People in Blaenau Gwent are concerned about what they see all too often: the anti-social behaviour, whether it's stones thrown at buses or drugs being used on the streets. They want to feel safe in their homes and safe on our streets. But they also recognise and understand that the policing response to these challenges are only a part of the question, a part of the answer, because the police have to work alongside local government, the education services, health, particularly in terms of dealing with some of the huge issues around mental health and drugs facing us today. They have to work with social services; they have to work across the whole range of services to provide a holistic response to the challenges that we face in our communities. People understand that. I am at a loss why the United Kingdom Government doesn't understand that.
I hope, Minister, in replying to this debate, that you will be able to confirm that you will be taking forward the work of the Thomas commission on devolving the police, so that we do have, in the future, not only a properly funded police force, where the police officers have the resources available to them to protect our communities, to protect our people, to keep us safe, so that they're not continually overstretched, under far too great a pressure as individual officers, but that they're also located and a part of the family of Welsh public services, working together within our communities for the benefit of the whole of our communities.I give way to the Member for Bridgend.

Carwyn Jones AC: I'm grateful to my colleague, Alun Davies. Does he share my bewilderment at the argument that, because crime is cross-border between England and Wales, as if that was a unique situation, it means that the larger country must therefore control the policing of the smaller country as well? Does that not mean that, sensibly then, the Republic of Ireland should be controlling policing across the whole of the island of Ireland? That is the logic of that argument. And does he also agree with me that, even though crime is cross-border, it is perfectly possible for policing co-operation to continue, as it does between the republic and the north, between England and Scotland, and there is no reason why the people of Wales cannot have control over their own police forces?

Alun Davies AC: I do agree very much with what the Member for Bridgend has said. And, of course, what the Conservatives are confusing is the detection of crime and resolving the issues arising from crime and finding the answers to crime. And I listen to Conservative Ministers who are very happy to devolve responsibilities to parts of England, to Manchester and to London, of course, but Wales isn't good enough for the Tories. The Tories never think that we are capable of managing these matters ourselves.
And the Member for Bridgend makes a very, very important point, and in looking at the wider issues of criminal justice, I cannot believe that any Welsh Government of any colour, of any stripe, would have allowed a situation to occur where there are no facilities for women in our criminal justice system in our country. That is a standing rebuke and a disgrace and something that the United Kingdom Government has to take responsibility for.

Thank you. Can I now call the Minister for Housing and Local Government to reply to the debate? Julie James.

Julie James AC: Thank you, Deputy Presiding Officer. I'd like to thank Members for their interests and their contributions today and reiterate once more my thanks to the police service across Wales, particularly in the light of their efforts in the recent flooding events.
I'm not too sure where the first contributor, Mark Isherwood, was going as he started, but it was quite obvious that he sought to lay the blame elsewhere for his Government's obviously poor choice in cutting funding to the police, a poor choice that reverberates still today, as all other contributors acknowledged.
Community safety is a top priority for this Government and, whilst this settlement is better than some may have expected, we are under no illusion that one better settlement makes up for the previous 10 years under the UK Government's austerity agenda. Indeed, some police and crime commissioners have expressed concern that, whilst additional funding has been provided for some new officers, there is insufficient funding for the existing complement. This, of course, is a matter for the Home Office and we urge them to address it as an urgent priority.
We are committed to working with PCCs and chief constables to ensure that these challenges are manged in ways that limit the impact on community safety and front-line policing in Wales. Continuing to work in partnership to identify and take forward opportunities is as important, as is demonstrated by a successful deployment of the 500 community support officers.
We also, of course, continue to push for the devolution of criminal justice and policing in line with the Thomas commission's recommendation. I could not agree more with the comments of various contributors around the Chamber: it makes no sense at all that policing is not devolved when all other blue-light services are devolved, and it quite clearly would be better if we co-ordinated the thing entirely from a devolved point of view. I wholly endorse all the contributions on this point, and particularly Carwyn Jones's excellent summation of how idiotic the argument made the other way actually is.
Having endorsed that thoroughly, Deputy Presiding Officer, I commend this settlement to the Senedd.

Thank you. The proposal is to agree the motion. Does any Member object? No. Therefore, the motion is therefore agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.

9. Debate: Cardiff Airport

The following amendments have been selected: amendment 1 in the name of Darren Millar, and amendments 2 and 3 in the name of Caroline Jones.

I now move to item 9, which is a debate on Cardiff Airport and I call on the Minister for Economy, Transport and North Wales to move the motion—Ken Skates.

Motion NDM7290 Rebecca Evans
To propose that the National Assembly for Wales:
1. Recognises the economic and social importance to Wales of Cardiff International Airport.
2. Welcomes that Cardiff International Airport is now responsible for the operation of Anglesey Airport’s passenger terminal facility and recognises the important regional air link between north and south Wales.
3. Recognises that over 1700 people are employed at the Cardiff Airport site and the £250m of GVA benefit it brings to Wales’s economy.
4. Agrees that it is vital for Wales’s trading economy post-Brexit to support Cardiff Airport as part of a high quality, integrated and low carbon public transport system in Wales.
5. Notes the UK Government’s interventionist approach to rescuing Flybe but calls upon the UK Government to go further to boost competitiveness by supporting the cost of regulation at the UK’s smaller airports, as happens across Europe.
6. Calls upon the new UK Government to finally allow the devolution of Air Passenger Duty in full to Wales.

Motion moved.

Ken Skates AC: Diolch, Dirprwy Lywydd. I'm proud of what the Welsh Government has done to support Cardiff Airport, a vital part of Wales's economic and transport infrastructure, and I'd like to begin my contribution today by making one very clear point. In 2013, the airport, had it continued under the existing commercial management, would have closed. It would have closed. Jobs would have been lost. We would have lost the main arterial air route into the south Wales, and businesses, exporters and travellers would have lost the opportunity to utilise an airport closer to their homes and premises than Bristol and Heathrow, and many other airports.
Since the Welsh Government stepped in to save the airport, we have invested in it, and delivered improvements to the terminal building and runway facilities. That investment has been recognised by the aviation industry and has led to a portfolio of airlines establishing new routes from Cardiff Airport to destinations around the world.
Cardiff Airport now directly supports more than 2,000 jobs and in 2018 delivered almost a £0.25 billion of gross value added to our economy. But the catalytic effect of the airport is even more significant, with economic analysis suggesting that Cardiff Airport is worth up to £2.4 billion to the UK economy. It leverages 5,500 supply-chain jobs and a total of 52,000 jobs in the wider economy. So, now is the time, I believe, whatever our political views, to come together to support this vital economic asset and strategic piece of transport infrastructure.
Now, in the early hours of last Wednesday, the devastating news of Flybe going into administration was announced. It's true that Flybe will impact Cardiff Airport in terms of passenger numbers. But I want to congratulate the airport team for moving rapidly to secure the Cardiff to Edinburgh route with Loganair. And I'm pleased to say, Dirprwy Lywydd, that discussions with other airlines are ongoing, and last week I had discussions with the Secretary of State for Wales and the UK aviation Minister. I've spoken on a number of occasions to the airport chief executive and chair to discuss how we can support discussions on route take-up; most recently, yesterday afternoon. And despite the loss of Flybe, the financial impact relates to just under 6 per cent of the airport's turnover. This is testament to the excellent planning and management at the airport.
Dirprwy Lywydd, I welcome scrutiny. It's right and proper that the National Assembly for Wales scrutinises the Welsh Government. It's right and proper also that we are scrutinised on our stewardship of public money and of the environment. It's also right and proper that we debate the future of the airport. However, Dirprwy Lywydd, it is not right and proper to talk down the airport. Can I make it clear that we are not wasting millions of pounds of taxpayers' money? We're investing in the long-term future of the airport in providing a commercial loan repayable, with interest, to the taxpayer. Due diligence has been taken and the support is in line with EU state-aid rules. And I wish to work collectively with Members to support Cardiff Airport and I would ask Members to reflect on this offer as this debate continues. Nick Ramsey.

Nick Ramsay AC: Thank you, Minister, for taking the intervention. As you know, as Chair of the Public Accounts Committee, which has been looking at this issue recently, we as a committee certainly have no interest in talking Wales down or being negative for negative's sake. You will know, however, that we have asked officials, in terms of those loans and those repayable loans—we accept that loans are necessary, but it is important that there is clarity on when those loans start to be paid back and the end point of that process as well. So, would you accept that there is an issue here that needs to be addressed, and, yes, you are right to invest in the airport, but would you agree that the public do need to have confidence that that process is not effectively a blank cheque?

Ken Skates AC: Absolutely, I would. Absolutely, I would, and I'd say to the Member as well, I welcome PAC's interest in the airport. And in terms of when those loans should begin being repaid, it's obviously for the airport to judge what is in its best financial interests, and this answer has been given to, certainly, the Economy, Infrastructure and Skills Committee.
Now, before talking further about the specifics of Cardiff Airport itself, I think it's important that we actually place this debate in the right context that it deserves. And Dirprwy Lywydd, we are facing challenges on a global scale: our climate is changing rapidly; we're seeing the impact now that the coronavirus is having on the economy and on the people of this world; Brexit is fundamentally reshaping our trading and external relationships; and recently we've seen refusals for three major airport expansions at Heathrow, Stansted and Bristol—all on environmental grounds. So, all of this creates not only challenging market conditions for aviation, as demonstrated by the recent collapse of Flybe, but important questions about the role of aviation policy in Wales. And I believe that it's important to address this head on, to develop our understanding of the evidence base around the airport's carbon emissions, to look at how Cardiff Airport could become a UK centre of excellence for low-carbon aviation, and, of course, to understand the role and the potential of Cardiff Airport in our post-Brexit existence.
The Cardiff Airport master plan for 2040 offers an opportunity to address all of these challenges, including the potential for a sustainable transport interchange and also sustainable locally owned energy. Ownership of the airport gives the Welsh Government a unique opportunity to lead the way in developing low-carbon and technological solutions for the industry. And we are in discussions, I'm pleased to say, with universities and with industry partners who are keen to utilise the airport as an exciting test bed.
The strategic social importance of Cardiff Airport is demonstrated most by the connectivity created between north and south Wales. This link is important for both the social and economic connections between the north and south of our country. And the route, I'm pleased to say, has grown in passenger numbers under Eastern Airways, who were recently awarded the contract for a further four years. Moreover, Cardiff Airport is now responsible for the operation of Anglesey Airport's passenger terminal facility.
But turning back to Flybe, I'd like to say that our thoughts go to the employees and passengers who have been affected by its collapse. We do regret that the UK Government's failure to intervene in the Flybe situation has led to such devastating consequences. We consider this to be symptomatic of the negative policy position it takes in relation to regional airports and to regional connectivity across the United Kingdom. It is within the UK Government's gift to vary its interpretation of state-aid rules to align with the rest of Europe, and to remove the regulatory costs that burden smaller, regional airports. So, once again, I call on the UK Government to devolve air passenger duty to Wales, as it has done for Scotland and for Northern Ireland. The airport is a valuable, strategic national asset and one that we should all be immensely proud of.

Thank you. I have selected the three amendments to the motion, and I call on Russell George to move amendment 1, tabled in the name of Darren Millar. Russell.

Amendment 1—Darren Millar
Delete all and replace with:
To propose that the National Assembly for Wales:
1. Notes news that Flybe has entered administration and expresses concern about the potential adverse impact of this on the future of Cardiff Airport.
2. Calls on the Welsh Government to publish a comprehensive strategy for Cardiff Airport with the aim of returning it to the commercial sector at the earliest opportunity and at a profit to the Welsh taxpayer, and that the strategy should include plans to:
a) invest in the airport's capital infrastructure to enable the airport to diversify and generate new sources of revenue;
b) support route development, prioritising a direct flight link to the USA and one to Manchester given its status as a major hub in the north of England serving north Wales;
c) develop a new marketing strategy for the airport;
d) work with the UK Government to devolve and scrap Air Passenger Duty;
e) improve transport links to the airport to make the airport more accessible by investing in improvedroad, rail and public transport links.

Amendment 1 moved.

Russell George AC: Thank you, Deputy Presiding Officer. Can I thank the Government for bringing forward this debate today? I think this is an appropriate debate to have, and I also appreciate, when the Government tabled this debate, at that point, Flybe hadn't gone into administration, which makes it, of course, all the more important that we have this debate today. And like the Minister said, it's also right to pay tribute to the dedicated staff of Flybe, and also the loyal customers, of course. And I appreciate that there's still much concern and much work to do, and I'm pleased that the Minister's outlined a number of meetings that he had last week in terms of the support for further routes to and from the airport. I think that's to be welcomed.
I certainly hope that our Welsh Conservative amendments to this debate today are seen as constructive. I do believe that they are. They are our plan from these benches in terms of where we believe the direction of the airport should go. In doing that, I should also, Deputy Presiding Officer, move our amendments, put forward in the name of Darren Millar.
But I actually think that there's much that we can agree on between the Government's benches and our benches, and in fact between other Members as well. I think we've all got the same long-term aspirations for the airport. The Minister said in his opening comments that whatever our particular views are, we want to support the airport, and I agree with that. There's much that we can agree on. I think where the disagreement perhaps comes is how we get to the objectives that we both want to see.
I put on record, of course, that our view is that Cardiff Airport should be returned to private ownership. In saying that as well, it would be useful perhaps to have some clarification of the Government's position on that, because it's certainly—and I stand to be corrected—

Mick Antoniw AC: Will you take an intervention?

Russell George AC: In a moment, yes. I stand to be corrected, but certainly the previous First Minister, I understood, did see Cardiff Airport being returned to private ownership, but I'm not sure what the Government's position is now.
There are two interventions now. I'll go for Mick first.

Mick Antoniw AC: Thank you for taking the intervention in respect of literally your ideological views in respect of privatisation. But would you agree that the privatisation that occurred in 1995 of the airport turned out to be an absolute disaster?

Russell George AC: I'm happy to take an intervention from Carwyn Jones as well. [Laughter.] I'll answer that.

Carwyn Jones AC: I'm grateful. Two brief point. First of all, just to remind you of course that the Conservative mayor of Tees valley has indeed bought Teeside airport and branded it as an airport for the people. I wonder how that fits with his argument. Secondly, just as a matter of information, what I said when I was formerly First Minister—I'm not now—is that in time there was scope to sell off shares in the airport but to keep 50 per cent plus one share in the hands of the Government in order to keep a controlling share.

Russell George AC: Well, thank you for that clarification. It would be useful to know from the Minister, at the end of this debate, if that remains the Government's position as well.
In terms of the other airport that Carwyn Jones mentioned, of course that was purchased for a fair price. I don't know the details of that particular airport, but what I will say is this: we, on these benches here, do believe that Cardiff Airport would be best run in private ownership. We don't believe that Governments are good—. They're not aviation experts and we believe that the airport is better run in private ownership. But I appreciate, as Mick Antoniw said, that there's a difference of philosophy in terms of where we stand on this. You can still support an airport without buying an airport, of course.
But let's also have an honest debate in this Chamber about where we're at as well. Previously the Government has talked about the increase in passenger numbers. Yes, it's great that the passenger numbers are growing, but let's remember that in 2007 passenger numbers were at 2.1 million and the Government's own plans and projections tell us that we'll hit that 2 million figure, which is an important figure in terms of the break-even point we're told, when the airport will return back to making a profit, we were told originally that that would be in 2021, now we're told that that will be in 2025. So, we've got to put into context some of these figures. There's often a lot of spin, I'm afraid, around some of the statistics that we see in terms of the airport.
Let's also be realistic about the financial position of the airport. Since it's been in Government ownership, there's been pre-tax losses that have been made every single year whilst it's been in the Government's ownership, and £18.5 million of pre-tax losses last year. Also, of course, in 2014 the net assets of the airport were worth £48 million and now they're worth—according to the balance sheet of the airport—£15.7 million. I appreciate what the Government Minister says in terms of the value of the airport in terms of other wider economic benefits, but let's also remember these statistics at the same time.
I appreciate that I'm running out of time, but I think I took an intervention. Am I allowed a couple more minutes?

No, no, you can finish your speech as quick as you can and I'll tell you when you've gone over time. Go on.

Russell George AC: Thank you. I was just looking for some guidance. Thank you, Deputy Presiding Officer.
But, certainly in terms of our plan for the airport, we have a number of points that we would bring forward. First of all, we would invest in the airport's capital infrastructure to enable the airport to diversify and generate new sources of revenue. I think that's important. This airport, of course, could be a symbol of great prestige and a gateway to Wales, and I often agree with points that Carwyn Jones makes in terms of the perception of Wales having an airport. Even if that might not be serving the whole of Wales, there is a perception issue there, which I would entirely agree with. There's also the support that certainly a Welsh Conservative Government would bring in terms of prioritising direct flights to the USA and one to Manchester. Manchester is especially important, given its status as a hub in the north of England, also serving the north of Wales. We'd also develop a new marketing strategy for the airport. I think that's important as well, and also, to put it on the record, we would absolutely, as Welsh Conservatives, be seeking from the UK Government to devolve air passenger duty and, once it is devolved, to scrap it as well. So, I appreciate we're at a difference, odds, to the UK Government, but that's our position here as Welsh Conservatives. I think—[Interruption.] I can't—

No. No, he's way over time.

Russell George AC: —or I'd be happy to. And, finally, we'd also want to see improvements in terms of transport links to the airport in terms of rail, road and public transport as well. But we on these benches do believe there should be a fair return for the taxpayers' money, the investment. Each taxpayer in Wales paid £38.50 for that original investment in Cardiff Airport, and we'd want to see that, of course, returned to the Welsh taxpayer.

I call on David Rowlands to move amendments 2 and 3, tabled in the name of Caroline Jones. David.

Amendment 2—Caroline Jones
Add as new pointat end of motion:
Looks to Cardiff International Airport to make annual profits at least at the operating level, i.e. before finance costs.

Amendment 3—Caroline Jones
Add as new pointat end of motion:
Calls upon the Welsh Government to seek a private sector partner to help operate and take a minority stake in Cardiff International Airport within5years.

Amendments 2 and 3 moved.

David J Rowlands AC: Diolch, Dirprwy Lywydd.Can I open by saying that the Brexit Party will be supporting the Government's motion? We will not be supporting the Conservative amendments, although there are a number that we would support, as we note the irony of their call for the Welsh Government to invest in the airport infrastructure, given their repeated opposition to the Government's past investment strategy for the airport. We would like to note here our past record in supporting the Welsh Government's decision to buy the airport, which undoubtedly secured its future. Quite apart from the airport's economic impact on Wales generally and on job creation for the region, we believe Cardiff Airport plays a crucial role in projecting Wales to the world.
Whilst our first amendment seems to have been achieved, as this was confirmed by the airport's chairman, Roger Lewis, in the briefing session held by the airport officials last week, our second amendment calls for the Welsh Government to seek private investment within five years, but we wish to note here that this should be on a minority basis, with the Welsh Government keeping at least 51 per cent of the equity. We believe this would be the only way to protect the airport's survival long term. We also wish to acknowledge that recent events, such as the collapse of Thomas Cook and, most recently, Flybe, will have a short to medium-term effect on the airport's finances, as could the potential for a catastrophic effect ensuing from the coronavirus epidemic. One can only surmise that, had the airport remained in private hands, its very existence would have been in jeopardy. We should also recognise that there may be a short-term need for the Government to give further financial support to the airport should the coronavirus situation take a serious hold. However, we would hope that, in such an eventuality, the UK Government would commit to supporting the air industry in general.
We also endorse the calls by the Government and the Conservatives for the UK to devolve air passenger duty. Their present stance is totally indefensible, given that this tax has, for a long time, been devolved to the Scottish and Northern Ireland Parliaments.
Finally, we issue a call for further investment by the Welsh Government to establish far better access to the airport, with a direct link from the M4, and even the possibility of a rail link. Such investment could dramatically affect the success of the airport.

Mick Antoniw AC: Can I just say that I've got a longstanding interest in the airport, because, when it was in public ownership, when it was owned by the three counties, I was a member of the airport committee at that time, as a councillor? I remember the annual reports, really, of public investment to actually build up the airport and to actually fund the first major international-length runway that enabled jumbo jets to land. Year on year, that airport expanded and, in actual fact, its passenger numbers were on a par at that time with Bristol. So, there is an ignominyto the fact that you had a publicly owned airport that was part of an integrated economic plan, that was serving the public and business within Wales, and then a bizarre ideological decision was taken by the Tory Government that it had to be sold off.
I appreciate, when I put the intervention to Russell George that the privatisation was a disaster—. I appreciate that he has difficulty admitting that it was, but you know it was and I know it was an absolute disaster. In actual fact—

Russell George AC: Will you take an intervention?

Mick Antoniw AC: Yes, please, certainly.

Russell George AC: The point is that the Government—in fact, all Governments—could have done more to support the airport during that time, such as road links, public transport links, rail links. All Governments of all colours could have done more to support the airport when it was in private ownership, and perhaps we wouldn't have got to the position we have done now.

Mick Antoniw AC: Well, I'm glad to hear your support for investment in our airports, but you don't—[Interruption.] But you really don't answer the point that the privatisation was a disaster, just as the privatisation of the railway network has been a disaster, just as bus privatisation has been an absolute disaster.
In 2012—the last year that it was in private ownership—it actually suffered a loss in that year of almost 17 per cent in passenger numbers. It is absolutely right: we would not, in Wales now, have an international airport if the Tories had been running the country. We would also have lost 2,500 jobs, we would have lost the contribution of hundreds of millions of pounds to the Welsh economy, we would have lost a key component in the development of an aviation industry that's actually quite important within my constituency. So, the actual decision by Welsh Government—by a Labour Government—to step in and repair that damage was fundamentally important.
Now, when the airport was taken into public ownership, the Tory Member of the European Parliament for the south-west, Ashley Fox, criticised Welsh Government rescuing it, because it challenged Bristol Airport. So, you have the English Tories actually supporting their regional airport. You can only ever dream, can't you, of a Welsh Conservative Party supporting a Welsh airport and Welsh industry? Their total—[Interruption.] Their total subservience. And that is the reality of the situation—Bristol Airport has flourished at the expense of the privatisation of Cardiff Airport.
Now, we need to move on, because we have Qatar Airways, which has made a very significant impact on the airport, and, of course, the chief executive officer of Qatar Airways basically says it should be left in public ownership, because to put it into privatisation would put it at risk of hedge funds and the international markets.
There's no doubt that the airport industry is going through a difficult time. There is no doubt we are still being disadvantaged in decision making by the UK Government, and I suspect the Tory influence over Bristol actually has an impact on that. But there is no doubt that, since we took it into public ownership, there has been a 60 per cent growth in passenger numbers in the airport. It now has a role within an economic plan. Investment in the airport is not only necessary but modest. The £38 million invested in Cardiff Airport, compared with the £500 million debts of Bristol Airport, I think stands by comparison, and I think we will need to invest further.
But the reality is that that investment or those loans that are made are at a commercial rate, because to do otherwise would be in breach of either EU rules or in breach of World Trade Organization state-aid rules. So, Deputy Llywydd, the airport has become a really important economic asset for us. It is also—. One has to say: what would be the status of Wales, of this country that we represent, if we did not have an international airport, if we could not bring major international figures—major sporting figures, economic figures and political figures—into our own airport, that we had to say, 'No, you have to divert via Bristol'?
Dirprwy Lywydd, the crux of the matter is this: the Tories almost destroyed our airport. We have rescued that airport. The airport now has a future. It is certainly a difficult time, but I know that it will survive, and it has to survive, because it has a Government that supports it and values it.

Nick Ramsay AC: It's a pleasure to contribute to this debate. I was a bit overeager earlier in that I made one of my substantive points, actually, to the Minister not long after he started speaking. He enthused me so much that he knows where I'm coming from on this.

Nick Ramsay AC: It's quite clear that an airport such as Cardiff is an important piece of not just Welsh transport infrastructure, but also of the UK transport infrastructure as well and, indeed, of course, as a link to other parts of the world and, more recently, to Qatar through the links made with that airline, of course, becoming a global hub as well. And the issue of funding is, I don't think, in doubt. Of course, an airport like that needs support and, of course, as Mick Antoniw said, commercial loans form a part of that, because, of course, with state-aid rules, those are going to have to be of a commercial nature.
The issue that the Public Accounts Committee has looked at in detail is the long-term sustainability of that type of funding, and what, importantly, would happen at a point in the future where those loans weren't available. If we just look in detail at the loans that have been provided, the airport has now fully drawn down the loan facility of £38 million. The most recent £21.2 million has, I believe, been consolidated with the existing facility, although the Minister might want to clarify that, as there was some questions raised about that during the recent committee meeting.
So, importantly, what is the future strategy for Cardiff Airport, and at what point are these loans no longer going to be available? I made the point earlier about a blank cheque, and it's important that the public have the confidence that, at some point in the future, either the airport will continue to be funded and that is part of the strategy, and the Welsh Government may want to say that is how we see it surviving in the future, or it will be able to stand on its own two feet. That's probably not the appropriate phrase in this context, but I think that's what the public look at, and that's what the Public Accounts Committee look at, in terms of the viability of this piece of infrastructure.
We're currently looking at another loan of a further £6.8 million, I believe. So, there is more money going towards the airport. We've only seen recently, with the consequences of Flybe, that, whatever strategy the Welsh Government develops, and however in the future it sees that vision for the airport developing, it has to be futureproofed against future shocks, such as the collapse of an airline. The collapse of an airline can have a totally disproportionate effect on the running and the financial viability of an airport, far more than in any other type of transport infrastructure or transport hub. We took evidence from Roger Lewis that confirmed that—that, actually, when it comes to the running of an airport, the potential catastrophic loss of one airline can have a major effect.
We were reassured, I have to say, that Cardiff, unlike some other airports, actually isn't as dependent—I can see the Minister nodding. It's not as wholly dependent on one airline as others, and I think that that has shown where there really has been progress made with that airport. I know often Welsh Government seems to think that this side of the Chamber is just overtly negative, talking Wales down—I can see Mick Antoniw nodding; I'm going to turn that round in a minute—and not looking on the bright side, but, actually, I'm willing to accept as the Chair of the Public Accounts Committee that there have been some good changes made, and, at certain points in the past, that airport did not look viable, so things have moved on and there have been structures put in place. But it's important in the future that there is a vision for that airport that supports what the Welsh Government wants to do with it.
Can I just mention air passenger duty? The former First Minister, who contributed earlier sitting in on this debate, used to like to talk, when he was First Minister, about the tools in the toolbox, along with the former finance Minister, and APD is clearly a potentially very important tool in that toolbox. I agree with other people who have spoken on all sides of the Chamber, including this one, that that should be devolved. It is nonsensical that other parts of the United Kingdom have access to that sort of devolution of taxation and the transport Minister here doesn't, and the finance Minister doesn't. That isn't fair, that isn't right, and we have supported you consistently in saying that that should be devolved. I think if the Welsh Government did have air passenger duty devolved to it, then it would at the very least open up the options available to you in supporting pieces of major infrastructure like Cardiff Airport. And, for the good of all of us, for the good of the Welsh Government, for the good of the public, for the good of all of us who contribute in these debates over many months, I think that in the future we want to get to a position where that airport, yes, is funded, but ultimately becomes sustainable so that Wales can have an airport that it can be proud of.

Helen Mary Jones AC: I rise on this occasion to support the Government motion—and these benches will not be supporting any of the other opposition amendments—unusually for me. Some Members who don't know me as well as others will be very surprised to hear that I love a bit of consensus, me. It's been really good to see that there is an element of consensus around this debate. We all do agree that our nation and this part of our nation needs a viable airport; we may have differences about how we want that to be run in the long term. It's been really encouraging to see, Dirprwy Lywydd, that we have consensus about the devolution of air passenger duty.
We can't do without an airport. In the longer term, we all know that we need to reduce the amount of air travel that we have, but there is also clear, consistent academic evidence that regions without their own airport suffer from that. There is the practicality of people moving in and out, but there is also that message—and others have mentioned this—and needing to send out that message that Wales is open for business, that we are here. And I think we do have to remind ourselves of the history here: there's absolutely no doubt that we would have lost that airport if the Welsh Government hadn't stepped in. That's completely clear. And at risk of breaking down this consensus, I do completely agree with Mick Antoniw: privatising the airport was never the right thing to do; it was always going to be challenging, when it had such a close competitor in Bristol, to make it viable without an element of public support.
Now, on these benches, we are very relaxed about this major piece of infrastructure being in public ownership, because we are very well aware, as others are, that this is normal. In lots of other parts of the developed world, it is perfectly normal for Governments to own, support and run, albeit at arm's length, key pieces of infrastructure, because those Governments know that the markets cannot always be trusted to deliver for the people. Sometimes they do, but in this case, they clearly would not have done, and we would clearly have been without an airport.
I want to just touch briefly on the devolution of air passenger duty. As I've said, I'm really glad to hear the Conservative benches wholeheartedly supporting it. It is, as somebody said, indefensible and iniquitous that every other part of the UK has this tool that they are able to use in whichever way they see fit. And there lots of ways that it could be used: it could be used to attract new carriers; it could be used to penalise people who fly too often or who fly for unnecessary reasons. But we need to be making those decisions here. It is not appropriate.
Now, I suppose I'm a little bit concerned, given that our Conservative colleagues have told us they've been advocating this for a long time, that they appear to be being ignored at the other end of the M4, and I wonder if this is something to do with the previous Secretary of State for Wales's apparent obsession with cross-border economic regions. I wonder whether he was perhaps a little bit too interested in the long-term viability of Bristol Airport, not that we wish any ill to Bristol Airport, but if it's either/or, I know where I want to be putting our resources.
I am optimistic, though, given what's been said today, that with a new Secretary of State, with a very clear message from the Welsh Government, but also today from this Assembly, that we can send that message very clearly to the new Secretary of State and ask him to advocate for this position. The current situation is just not defensible. It isn't fair, it isn't just, and long term it won't work.
With regard to points 5 and 6 of the motion, I just want to say a little bit more about point 5. The Flybe situation was disappointing, and I want to express my gratitude to the Minister today, because he has kept us very much informed about the developments. When you heard that a quarter of the flights going out were Flybe flights, it was a moment of being really, really concerned. As others have said, our thoughts have got to be with those people who are at risk of losing their jobs, though I understand—and the Minister may be able to confirm this today—that some of those jobs, the ones in Cardiff Airport, have already been protected by other carriers; and the passengers for whom it was hugely disruptive—people who couldn't go to job interviews, people who couldn't go to family occasions. But, of course, those people might not have been able to go at all if we hadn't had an airport. But, I'm very grateful to the Minister for keeping us in touch.
It does beg the question as to whether or not the Westminster Government kept its promise to Flybe shareholders, but I think it's fair to say that this is a very challenging market. This is not the first regional carrier that has collapsed. What's really important is that we retain the viability of our airport. I was pleased to hear from the Minister that it's not as devastating as we thought it might have been.
So, we're happy today to support the Government in supporting the airport and to support the motion. We need to reduce, as I've said, our flying, but in order for that to be possible we need to have more effective regional connectivity. Until we have that, if we don't have our own airport, people will simply fly from elsewhere, so a thriving airport is vital to us all. We will support the Government motion today, and we will support them in continuing to support the airport. The Minister will, of course, expect us to scrutinise him rigorously as to how he does just that.

Jenny Rathbone AC: It's good to see that there's considerable unity around supporting our international airport, and I think it's good to hear the Chair of the Public Accounts Committee recognising some of the changes that have been made to make the airport viable. It's absolutely the case that, if the Welsh Government hadn’t taken it over in 2013, the airport would have closed. End of story.
We have to recognise that it's about 2,500 jobs directly or indirectly being maintained here in south Wales. In the difficult economic circumstances we find ourselves in, that's very important revenue. We know from the discussion we had with Cardiff Airport's senior executives on Monday last week that they are already earning more money than it costs to run the airport, and they have been doing so for the last three years. So that's a very important point, because were that not to be the case that obviously makes for a potentially very difficult situation.
We know that the tipping point is about 1.6/1.7 million passengers a year. So, obviously, we are in a dangerous situation at the moment as a result of coronavirus, which is obviously disrupting everything in terms of the world economy. But it is actually only £36.2 million, Nick Ramsay, that Cardiff Airport has drawn down so far of the possible £38 million—that's what we heard in the Public Accounts Committee. We need to place that £36.2 million commercial loan in the context of what other regional airports are carrying in the way of debt. We learnt last week that Liverpool has a debt of £102 million; Newcastle £367 million; Leeds Bradford £125 million; and Bristol Airport £590 million debt.

Nick Ramsay AC: Will you give way, Jenny?

Jenny Rathbone AC: Yes.

Nick Ramsay AC: Just on your previous point there, the statistic I've got in front of me is definitely that the Welsh Government has now fully drawn down that £38 million, but I'm willing to discuss that with you later. It may be that I've got the wrong end of the stick, but I think that that money has been drawn down.

Jenny Rathbone AC: Okay. I agree that £1 million or £2 million is a lot of money, but I think that the point is that they are still within the amount of money that's already been agreed with the Welsh Government, further to the collapse of Thomas Cook.
So, there's no doubt that the collapse of Thomas Cook, and indeed Flybe, and on top of that coronavirus, are delaying the timescale by which the company is able to repay the loan to the Welsh Government. And the company executives were perfectly frank about that, even though it was before we knew about the demise of Flybe.
But for every company that fails in normal commercial circumstances, there is another who is a potential beneficiary. So, we've seen TUI increasing the number of flights out of Cardiff. We've seen some of the Flybe routes taken over by Loganair. There'll always be commercial companies who will see somebody else'spain as a business opportunity, and that's absolutely fine.
I agree with Mick Antoniw that the previous Secretary of State for Wales should more accurately have been described as the Secretary of State for Bristol and the south-west, because he seemed far more interested in that. Quite why the Member of Parliament for the Vale of Glamorgan hated his local airport so much, only he knows. Maybe the flight path went over his house. [Laughter.]
But there are many reasons why Cardiff is more likely to survive the current difficulties for all airlines across the world than many other regional airports in the UK; it's because there are several features of Cardiff's airport that make it a much better bet in the long term. One is the fantastically long runway that we have got, which is far longer than the runway in Bristol or Birmingham, which means that it's ideal for long-haul airlines. Whatever the climate change emergency, it is difficult to envisage that all of us who need to travel to the United States are going to go by boat. Some people are going to continue to need to go by plane. So, having this very long runway—positioned mainly over the sea and agricultural land, which means it's far less disruptive than an airport in a built-up area—means that it's ideal for future runways.
On top of that, it's got the relationship with the British Airways maintenance centre, and it has the capacity to become a centre for innovation. For example, we discussed autonomous pods that are operating at Heathrow, which could be used to connect Rhoose station with the airport terminal, which would overcome one of the weaknesses that Cardiff Airport has at the moment. So, I think that this is an airport with a future, and is a very good Welsh Government investment.

Finally, Rhianon Passmore.

Rhianon Passmore AC: Thank you, Deputy Llywydd. It was reassuring to hear from the Minister that the recent and highly regrettable news that Flybe ceased trading on 4 March does not affect the overall viability of Cardiff Airport; but equally, aviation is indeed having a very difficult period, and we know that Brexit is playing its part in this.
But, the on the record doom-mongering from the Conservative Party opposite about the long-term future of the airport has proved to be unfounded, and it is unwelcome for the airport and those whose jobs rely on it. So, I also suggest that we do not talk Wales down. The day after the Flybe announcement, Cardiff Airport confirmed it had secured agreement with Loganair to step in and operate this crucial Cardiff to Edinburgh service starting on 23 March, so it's a shame that the party opposite did not welcome this. If they support the airport and they support Welsh infrastructure, it is my belief that they should.
It is also right, again, I think, to underscore here that Cardiff Airport is indeed an important piece of strategic transport infrastructure. It is a key economic asset for Wales, and as such its vitals are strong. Nearly 1.7 million passengers flew from Cardiff Airport in 2019. That's up 7 per cent on the year before, the busiest year since 2009, and up by 65 per cent since our Welsh Government involvement. Last year also saw the airport post a 34 per cent growth in commercial revenue. These are real facts.
There is much talk in this Chamber of Wales becoming a mature nation in its own right as a member of the United Kingdom family of nations. So, what self-respecting nation does not want or have its own airport servicing its capital city and the wider nation, and the 52,000 supply-chain jobs that go with it, including research and development? If we choose to shirk our national responsibilities to Wales, we would stand aside as regional English cities like Bristol and Exeter's airports grow. We are an aspirational and ambitious nation, and I know that the Welsh Labour Government will not shrink from standing up for Wales. It is vital for Wales's trading economy post Brexit to support Cardiff Airport as part of a high quality, integrated and low carbon public-transport system.
The Welsh Labour Government has also consistently called for air passenger duty to be devolved to Wales, and I'm glad that the Tories opposite now support it. I would ask them to take that message back to their UK masters. Independent expert analysis demonstrates clear economic benefits for Wales if air passenger duty is devolved, and obviously a subsequent decision taken by Welsh Ministers to reduce that air passenger duty. As the UK leaves the EU, the devolution of air passenger duty is a means by which the Welsh Government can promote the economic attractiveness of Wales, and growth in Wales in unison with the Welsh Government's existing economic policies, and is a key attraction for our investors. So, I'm pleased that there is now cross-party support across the Assembly for powers for air passenger duty to be made in Wales.
And I would also say—put it very simply, then—if Members do back Wales, then they will back the Welsh Government and Cardiff Airport. It is time that we all stand up for Wales, and it's time to end the talking down of Wales.

Can I now call on the Minister for Economy, Transport and North Wales to reply to the debate? Ken Skates.

Ken Skates AC: Diolch, Dirprwy Llywydd. I really am grateful for all Members' contributions this afternoon, especially to those Members who are supporting our motion, and to those Members on the Conservative benches who are now backing the Welsh Government position against UK Government policy.
I do feel that it is most important that we recognise that it's our collective responsibility to support and promote the airport—not to run it down on social media or to use it as a political football. You would never, never, ever hear elected public servants running down John F. Kennedy airport or Charles de Gaulle airport, or any other of the world's publicly owned airports.
Let me be absolutely clear, we will not allow Cardiff Airport to fall out of the control of the public of Wales, and operating on their behalf, the Welsh Government. Our position today remains consistent with our position in 2013, in 2014, in 2015, right through to the present day. We are, of course, open to private sector investment in the airport, and the potential for the private sector to take a stake, but we as a Welsh Government took back control of that vitally important piece of infrastructure, and we will retain control on behalf of the people of Wales.
A question was asked of me by Russell George—a very important question about what aviation experts believe is in the best interests of the world's airports: whether they should be publicly owned or privately owned. Now, when we talk about experts, Donald Trump, the President of the United States, he likes to consider himself an expert in lots and lots and lots of things, but you don't hear him rushing to try to find buyers in the private sector for all of those publicly owned airports in the United States. And as Helen Mary Jones said, public ownership is the global norm. In fact, around 85 per cent of the world's airports that carry passengers are publicly owned.
Now, I did hear David Melding joking, I think, about David Rowlands not being a capitalist anymore because he's a supporter of the public ownership of the airport, but you wouldn’t accuse President Donald Trump or former New York Mayor, Rudy Giuliani, or any of the other right-wing supporters of public ownership of airports in the US of not being capitalists. You would not accuse Nicolas Sarkozy and you wouldn't have accused Jacques Chirac of being anti-capitalist for their support of public ownership of Charles de Gaulle and many, many other airports in France.
Now, at the start of this debate, I offered to work collectively with Members in this Chamber, and that still stands. But, please, do not use carefully selected statistics and present them in a way that's designed to skewer the future of the airport. And today, I think that statistic that is most often used by those who wish to talk down the airport was once again raised, and it concerns the loan—the investment—that's being made in the airport. But as Jenny Rathbone rightly identified, that relatively small amount of investment in Cardiff Airport pales into insignificance against some of the debt that many other airports have, including Bristol Airport that currently carries a debt burden of more than £0.5 billion.
Now, Nick Ramsay, I thought, made a vitally important point—that it's essential that we consider the impact of the collapse of any airlines when we consider supporting the airport with commercial loans. I can tell Members that, as part of our due diligence, we stress-tested the financial strength of the airport against the collapse of Flybe. Now, Cardiff Airport is not in the same position that many other small regional airports are in today as a consequence of Flybe's collapse—airports such as Southampton, where 95 per cent of traffic was provided by Flybe, or other airports that are in similar positions, such as Belfast or Exeter—and that's because of the diversification that's taken place at the airport in the last two years. It was interesting last week, Dirprwy Llywydd, that the BBC re-ran a story online from 2018. The headline was something along the lines of 'Collapse of Flybe would be devastating for Cardiff Airport'. That is not the case today, but it would have been the case in 2018. I am convinced that, had the Conservatives won the election in 2016 and sold off the airport after that election, then today, as a consequence of Flybe's collapse, the airport would have collapsed as well.

Helen Mary Jones AC: Will you take an intervention?

Ken Skates AC: Yes, of course.

Helen Mary Jones AC: I'm grateful to you for taking the intervention. You may wish to take this opportunity to share with the Chamber the news that you gave me about the Flybe jobs that have already been saved at the airport. Of course, that's no consolation to those employed in other airports who were not so fortunate, but I think it would be helpful to have that on the record and perhaps reassuring.

Ken Skates AC: I think it's really important. Helen Mary Jones makes a really important point about the human impact of Flybe's collapse, and I am pleased to say that, as a consequence of Loganair intervening and taking up the Cardiff to Edinburgh route, they have prioritised jobs for Flybe staff and this includes at Cardiff Airport. I am also encouraged by very recent discussions that the airport is having with other airlines who also could step in and take over vitally important routes.
I'd just like to say that I am genuinely grateful to the Welsh Conservatives for their support of our position on air passenger duty and their support for the call for a route between Cardiff and Manchester to be established. It's ironic though because, of course, we asked the UK Government to promote a public service obligation from Cardiff to Manchester and they refused to do so, to the European Commission.
So, I ask for the support of all Members in calling on the UK Government to consider three vitally important measures in its review of regional connectivity. First, remove the regulatory cost burden on regional airports, as is done in Europe. Second, open up new public service obligation flights between the UK regions and also to Europe. Thirdly and finally, but vitally important, is air passenger duty: devolve APD to Wales so that we have control to deliver our policy objectives.

Thank you very much. The proposal is to agree amendment 1. Does any Member object? [Objection.] Okay. So we defer voting on this item until voting time.

Voting deferred until voting time.

Before we move to voting time and the Stage 3 debate on the Health and Social Care (Quality and Engagement) (Wales) Bill, I will suspend proceedings for 15 minutes. That's 1-5 minutes. The bell will be rung five minutes before we reconvene, but could I encourage Members to return to the Chamber promptly? So, a 15-minute break and the bell will be rung five minutes before we reconvene. So, the Plenary now stands adjourned.

Plenary was suspended at 16:38.
The Assembly reconvened at 16:59, with the Llywydd in the Chair.

10. Voting Time

We will move now to voting time. The only vote is on the debate on Cardiff Airport. The first amendment will be the first vote, and therefore I call for a vote on amendment 1, tabled in the name of Darren Millar. Open the vote. Close the vote. In favour 12, no abstentions, 38 against. Therefore, amendment 1 is not agreed.

NDM7290 - Amendment 1: For: 12, Against: 38, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 2: I call for a vote on amendment 2, tabled in the name of Caroline Jones. Open the vote. Close the vote. In favour 13, no abstentions, 37 against. Therefore, amendment 2 is not agreed.

NDM7290 - Amendment 2: For: 13, Against: 37, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 3—I call for a vote on amendment 3, again in the name of Caroline Jones. Open the vote. Close the vote. In favour 14, no abstentions, 37 against. Therefore, amendment 3 is not agreed.

NDM7290 - Amendment 3: For: 14, Against: 37, Abstain: 0
Amendment has been rejectedClick to see vote results

The next vote is on the motion tabled in the name of Rebecca Evans. Open the vote. Close the vote. In favour 39, no abstentions, 12 against. Therefore, the motion is agreed.

NDM7290 - Debate: Cardiff Airport: For: 39, Against: 12, Abstain: 0
Motion has been agreedClick to see vote results

11. Debate: Stage 3 of the Health and Social Care (Quality and Engagement) (Wales) Bill

The next item on our agenda is the Stage 3 proceedings on the Health and Social Care (Quality and Engagement) (Wales) Bill.

Group 1: Duty to secure quality in health services—workforce planning and appropriate staffing levels (Amendments 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34)

The first group of amendments relates to the duty to secure quality in health services—workforce planning and appropriate staffing levels. Amendment 21 is the lead amendment in the group, and I call on Angela Burns to move the lead amendment and to speak to the other amendments in the group. Angela Burns.

Amendment 21 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Thank you, Presiding Officer. I formally table the amendments here in my name. I would like to, at the outset, Minister, say that these are by way of probing amendments. You do have the opportunity, by your response, to ensure that we don't have to spend time in voting from 21 to 34.
These amendments have been retabled by us from Stage 2. They were previously tabled as a mix from Helen Mary Jones and from me, and they are in support of committee recommendation 4, because I think it is necessary to remember the Royal College of Nursing's comments on the Bill at Stage 1, saying that this Bill is an ideal opportunity for the Welsh Government to progress with the principles of the Nurse Staffing Levels (Wales) Act 2016 and to broaden its applicability. It's particularly relevant to section 25Dof this Act, which is about making sure that local health boards and NHS trusts may undertake these provisions in order to enable them to comply with their duties under this Act.
Now, surely this chimes with what the Minister also said at Stage 1, when he said that the duty of quality is more than just a cultural change, and I agree with him. To have a cultural change, all clinical staffing groups should be part of sufficient workforce planning. Amendment 33 outlines that the Welsh Government must take reasonable steps to ensure that there are a sufficient number of specific healthcare staff, including nurses, midwives and medical practitioners. As I noted at Stage 2, it was heartbreakingly clear in the case of Cwm Taf that a number of factors, including an insufficient level of midwives, caused the catastrophic collapse in the provision of safe care that we saw there.
So, we believe it's the Welsh Government's duty to ensure that it's not repeated again, and we think that this Bill is a very good vehicle to do that through. There is no routine reporting of midwifery vacancies, and Healthcare Inspectorate Wales's national review of maternity services in Wales won't be published until later this summer. So, without this key data on an ongoing basis, rather than a one-off review, we're not aware of whether there are enough maternity staff in every health board in Wales.
The first part of amendment 34, a duty to ensure appropriate staffing, is intended to hold the Welsh Government to the same standards and expectations as an NHS body. It does require the Minister to demonstrate what action has been taken to achieve this. Now, let me be clear, with the cases that we're now seeing of COVID-19 appearing in Wales, and noting the potential pressures on staffing that a full outbreak will have, now is the time to monitor pressures within the health system, so that we know whether our health boards are able to deliver those safe levels of care.
The second part of our amendment, the duty to have a real-time staffing assessment in place, will ensure that staffing levels are regularly monitored so that NHS bodies and Ministers actually respond to issues as they happen in real time, instead of only responding to agreed procedures from months or years before. As I noted at Stage 2, there are already issues with safe nursing levels, as the Royal College of Nursing is still concerned that neither the Welsh Government nor NHS Wales publish national figures for nursing vacancies using an agreed definition of what constitutes a vacancy. And annual data published by the Welsh Government on nursing levels does not adequately reflect patient need or service development, including comorbidities and an ageing population.
The third and final part of the amendment, the duty to have a risk escalation process in place, will give every single member of staff a clear mechanism to raise concerns if they are working in settings where they feel the levels of available staffing are not conducive to safety.
At Stage 2, it was noted by the Minister that he would not support these amendments—so, I understand that at the moment—as the Bill would not be the appropriate mechanism for enacting a change of this magnitude, and that applying any principles of the nurse staffing levels Act to all other clinical staffing groups in Wales without the same degree of consideration and scrutiny would be inappropriate and inconsistent. Yet, as we have so often said before with Welsh Government legislation, the Bill's provisions on the duty of quality are overly broad. It therefore risks becoming an aim rather than a duty, without specific mechanisms for health boards to undertake the necessary action to ensure it is upheld and monitored routinely.
I do also, Minister, dispute your concerns about the financial considerations, as having appropriate staffing levels in place will cost NHS bodies and Welsh Government less money in the long term due to less sickness and stress-related illnesses, as well as improved mental health for all staff. The amendments also recognise that the onus is not solely placed on NHS bodies, and that Welsh Government have a role to play in the long-term secure future of staffing levels for NHS bodies.
I do note the points that you raised in Stage 2 in your letter to the Chair of the Health, Social Care and Sport Committee on 26 February, in which you said that Schedule 3 to the Bill amends subsection 47 of the Health and Social Care (Community Health and Standards) Act 2003 to require NHS bodies to take into account the healthcare standards. However, as will be outlined in my amendments in group 7, these standards have not been updated since 2015. Since then we've had a rapidly ageing population, as well as advances in technology that mean they are fast becoming obsolete. Therefore, I would be grateful if the Minister could outline a timeline on the refreshed standards, as well as placing on record his commitment to a clear mechanism to review these standards regularly.
Minister, should you be prepared to answer these questions on the health and care standards, as well as commit to supporting amendments 36 and 37, I would be prepared to withdraw these amendments.

Rhun ap Iorwerth AC: We on the Plaid Cymru benches will be supporting these amendments, but I would like to take a few moments to explain how we will engage with this Bill more generally at the outset.
There are a number of reasons why we believe we're unable to support the Bill as currently drafted and that it's unlikely that we could support the Bill after we've gone through the process that we're going through today. There are a number of reasons for that, and the main reason is that this Bill would weaken the voice of the patient by abolishing the community health councils, which have been strong advocates for patients, and that's certainly true in the part of Wales in which I live, in north Wales. And there's also a failing in the Bill in providing instead of what we have now a model that would provide the same independence and the same understanding of the reality and the needs for health and care services in various parts of Wales.
But there are other parts of the Bill that we also think are inadequate. What we have here is a Bill that appears to be putting quality at the heart of service planning, but then fails to sufficiently, clearly and robustly define what the expected quality and standards are, referring rather to health and care standards, and the latest document that defines those is dated 2015, I believe. Therefore, there are fundamental weaknesses here that we regret that we haven't been able to tackle in an appropriate manner during this Bill's processes through the Senedd. And here I pay tribute to Helen Mary Jones for the work that she did as health spokesperson for Plaid Cymru during the earlier stages of this Bill's progress through the Senedd.

Rhun ap Iorwerth AC: Turning to the specific amendments, the Minister, I know, will no doubt say today that the health and care standards already consider the need for workforce planning. Standard 7.1 says that
'Health services should ensure there are enough staff with the right knowledge and skills available at the right time to meet need.'
Is that enough in itself? There are also a range of criteria that are used to explain what that means. That includes matters like attending training programmes, that the workforce are able to raise concerns, that health boards have effective workforce plans. That's what we're told currently. But I'll ask you, as Members: do we genuinely believe that these criteria are being adhered to at the moment? The evidence I see is that they are not, and we have an opportunity in this Bill to strengthen that. We need something more robust. I would suggest a direct reference to the workforce on the face of the Bill.
So, we'll support these amendments on the workforce because you cannot have an NHS without a workforce, and I sincerely hope that these amendments will pass.

Caroline Jones AC: I thought long and hard about whether to table my own amendments to this Bill, and in the end, I opted to support amendments put forward by my colleagues. The whole point of amending legislation is to improve it, to ensure that the resulting Act will benefit the people who chose us to represent them. Instead of us all going our own way with competing amendments, it was better to put aside party differences, and at the end of the day, it matters little to the people of Wales whether amendments were put down by the Welsh Government, Welsh Conservatives, Plaid Cymru or the Brexit Party. All that matters is that this legislation delivers upon its stated aim of improving quality and engagement in both health and social care.
I chose to support Angela's amendments in this group because, like her, I don't believe the Welsh Government has gone far enough in its duty to secure quality in health services. A lack of strategic workforce planning has left our NHS short-staffed, which, in turn, has had a dramatic impact on services in recent years. If we are to improve quality in health and social care, we have to ensure that our excellent staff have the time to care. Because Governments of all colours failed to do any adequate workforce planning, we have staff shortages across the board. Many hospital departments only function because of the heroic levels of determination of staff. Unfortunately, burn-out is all too real. We can only secure quality if we have our health and social care services staffed with sufficiently and suitably qualified and competent individuals, and I urge Members to support the amendments in this group.

Mark Isherwood AC: A constituent wrote to me last month after publication of the report on hospital vascular services' overhaul leaving people fearful in north Wales, this was written by the north Wales community health council, the public watchdog that holds the Betsi health board to account, and which the Welsh Government is considering disbanding—exclamation mark. As the sector has told me, only independent bodies give true challenge.
Community health councils were abolished in England in 2003. Abolition took three years against much opposition. The fate of English community health councils was sealed when the then UK Government did a deal with the Welsh, Scottish and Northern Irish administrations at the time, allowing them to keep their own community health councils if they supported the abolition of English community health councils.
The Francis report found that community health councils in England
'were almost invariably compared favourably in the evidence with the structures which succeeded them. It is now quite clear',
the report said,
'that what replaced them, two attempts at reorganisation in 10 years, failed to produce an improved voice for patients and the public, but achieved the opposite.'
And Andy Burnham, who was then an MP, doubted in retrospect the wisdom of abolishing community health councils. He said their abolition was not the then UK Government's finest moment:
'It seems we failed to come up with something to replace CHCs that did the job well.'
Well, the hands-on experience of those who worked in the organisations that followed community health councils in England was that effective monitoring and scrutiny was lost for a substantial period of time on each occasion there was a reorganisation.
As I said here three years ago, in terms of staffing, for year after year after year, Labour Welsh Government has dismissed warnings that we faced a GP crisis in north Wales, given by professional bodies, including BMA Wales, the Royal College of General Practitioners Wales, and by myself and shadow Cabinet colleagues on behalf of the NHS Wales staff and patients who've raised their concerns with us.
Speaking here in January, I noted that, at the end of 2019, the Royal College of Nursing launched its 'Progress and Challenge' report on the implementation of the Nurse Staffing Levels (Wales) Act 2016, which said that:
'The nursing workforce in Wales is facing a national crisis. The high number of vacancies...estimated...as around 1600 at a minimum'—
quote—
'are compounded by greater shortages in the care home sector and the prospect of significant losses to retirement over the next...10 years.'
They pose questions for the Welsh Government, including:
'How are the "special measure" arrangements'—
for Betsi Cadwaladr University Health Board—
'monitoring and supporting the board to be compliant with the Act?'
'Will you increase student nursing numbers as Betsi Cadwaladr University Health Board has requested?'
'Will you support the placement of non-commissioned student nurses'—
from Glyndŵr University—
'as the Betsi Cadwaladr University Health Board has requested?'
Well,BMA Cymru Wales is now calling for safe staffing to be enshrined in Welsh legislation, supported by the Royal College of Nursing Wales, Royal College of General Practitioners Wales, Academy of Medical Royal Colleges Wales, the Royal College of Physicians Wales, the Royal College of Surgeons Edinburgh and Royal College of Midwives Wales. They say the safety of patients depends on doctors and healthcare staff working in a safe system, but, due to the ongoing treatment and retention crisis in the NHS, doctors no longer feel this is the case, and fear the health of their patients is at risk. They say Wales has recognised the importance of legislating for safe nurse staffing levels with the Nurse Staffing Levels (Wales) Act. They say that Scotland has taken action to legislate on safe staffing with the Health and Care (Staffing) (Scotland) Act 2019, passed with cross-party support. They say that doctors are facing increased pressures, medical staff are being pushed to breaking point, and that vacancies continue to climb. They say there aren't enough doctors to fill rota gaps, and the inevitable knock-on effect is a drop in standards of care for patients.
Collectively, they strongly welcomed recommendation 4 from the Health, Social Care and Sports Committee report referred to by Angela Burns, recommending
'the Minister amends the Bill to make specific provision for appropriate workforce planning/staffing levels as part of the duty of quality.'
They said, 'We believe the guidance must be included in Part 2 of the Bill so that, at the very least, Welsh Government can introduce guidance to NHS bodies that informs them how they can achieve the duty of quality. This guidance should address the need for effective workforce planning.' A similar guidance process is set out in the section on duty of candour.
I therefore urge this Assembly to support Angela Burns's amendments. I welcome the support from across the Chamber, but note that, if the Minister is able to bring forward his own proposals to address these concerns, Angela would withdraw her amendments. We wait to hear what he might have to say. Thank you.

Vaughan Gething AC: Thank you, Llywydd. I want to thank, at the outset, people who have worked on this Bill to date, both the scrutiny we've had through the committee process, as well as officials and all those who engaged in the White Paper stages and wider consultation. We will have various points of disagreement, and some points of agreement, through the passage of this evening. I won't respond to some of the broader comments about the future arrangements to replace community health councils; we'll come to that group later in the Bill.
In terms of staffing, of course, this Government supports the principle of having sufficient staff in our health service: having the right staff in the right place with the right skills.
I want to address the amendments in this group in two parts: firstly, whether the definition of quality should explicitly include staffing levels itself, and, secondly, amending the Bill to include a staffing duty. 
I want to be clear: the duty of quality, as drafted, isdeliberately broad. It captures all aspects of the health service and relates to everything the health service has responsibility for. Workforce considerations are clearly a key enabler to meet the duty of quality. No body can ensure it secures services that are, for instance, safe and effective and provide a good experience unless they've given consideration to the types and the numbers of staff needed to achieve that.
And we are deliberately using the internationally recognised definition of quality put forward by the former Institute of Medicine in the states, and the person who went on to lead that institute was Don Berwick, who took part as one of our international experts in the cross-party endorsed parliamentary review. As I have said, having the right staff in the right space with the right skills is, in effect, the resource needed to secure improvements in quality. Staffing in and of itself is not defined as meaning quality. The workforce is there a key and most significant enabler in being able to secure improvements in quality.
Now, as has been said, Schedule 3 to the Bill links the duty of quality to the health and care standards, which have a whole theme, with detail on them, on staff and resources. NHS bodies will therefore need to demonstrate that full consideration has been given to workforce matters in discharging the duty of quality.
As I've indicated previously, and in particular in the useful and constructive discussions we had after Stage 2 with other parties, the standards are kept under regular review, and, in fact, a review is about to take place within this year. The passage or otherwise of this Bill will obviously help to inform the review of those standards and the framework we expect people to respond to.
The statutory guidance will deal with the application of the duty across all functions of the health service, and will undoubtedly highlight the importance of workforce planning, alongside the requirement to consider securing improvements through areas such as prevention, health improvement, and taking action to address inequality in outcomes.
I'm pleased to confirm that the RCN and the BMA have offered to work with us on developing the guidance, and of course I very much welcome that offer. The amendments on staffing levels being included in the definition of quality are not, therefore, in my view required.
Turning to the amendments that seek to extend the staffing duty to Welsh Ministers, I have to say at the outset that I'm firmly of the view that making a change of this magnitude by way of amendments to a Bill is simply not the right approach. The Nurse Staffing Levels (Wales) Act 2016 benefitted from significant planning and considerations of the financial ramifications, and was subject to the full scrutiny that we would all expect for such a landmark piece of legislation. And it was important to ensure that it was done in the right way. Applying any of the principles of that Act to all other clinical staffing groups in Wales without the same degree of care, consultation, consideration and scrutiny would be wholly inappropriate.
The Royal College of Nursing in their own evidence to the health committee acknowledged that a change of this magnitude is not something that they believe is suitable to try and achieve by way of an amendment. When you consider not just the headline measures, but also the process measures as set out in the highly detailed amendments for reporting mechanisms, you would have to do a considerable amount of financial work on the workforce implications as well as the availability of staff and having the tools to calculate staff—the appropriate levels of staff—in different settings.
In the case of inserting a section 25AA, as set out in the amendment put forward by Angela Burns, it would inappropriate and impracticable to level such a duty on Welsh Ministers when it is health boards and trusts who have that operational responsibility for those staffing considerations. The proposed amendment is in essence an extension of section 25A of the Nurse Staffing Levels (Wales) Act 2016 to all clinical staff, and it's very clearly a duty for health boards and trusts.
It is important to recognise that NHS bodies already have arrangements in place for ensuring that managers and senior decision makers are informed of staff shortages where this is likely to present a risk to patient safety. These arrangements include decisions to be taken 'in-hours' and 'out of normal working hours', and that includes arrangements for informing executive board members where appropriate, for them to make choices.
I am therefore unable to support the amendments put forward in this area, and ask Members to oppose them.

I call on Angela Burns to reply to the debate.

Angela Burns AC: Diolch, Llywydd. I guess your answer's no real surprise, Minister, to any of uswho believe really passionately that, to have a duty of quality, you need to have the right staff in the right place at the right time. And I think to those of us who've seen over the last few years again and again the instances where there haven't been enough staff and they haven't been in the right place and they haven't been at right time, and it has led to some very, very sad and demoralising situations within the NHS—.
That initial legislation, when it first came in, as introduced by your Cabinet colleague Kirsty Williams, was groundbreaking. But we've done nothing to build on it, and we've done nothing to really take it forward. Now this supports a recommendation in the health committee. This was a recommendation where we took an awful lot of witness evidence. This is what the specialists are saying. This isn't just Angela Burns, Welsh Conservative, or Rhun ap Iorwerth, Plaid Cymru, or Caroline Jones, Brexit Party, just trying to be difficult and invent something. This is actually as a result of really considered evidence by the specialists. And if you ever say it once when you stand up in this Chamber, you say it many, many times: 'We must listen to the clinicians. We must listen to the professionals.' We did. We did, hence these amendments.
I've never been one for legislation lite—I do believe, if you do legislation, you have to do it really well, so it has a really effective part. And the whole point of this Bill is about quality and about candour and about patient representation. And I fail to understand how you can possibly hope to deliver that level of quality if there are chances that you do not have the right staff, whatever they are, in the right place at the right time.
And I will just add one last thing, which is you make the comment that health boards are already supposed to be doing this. Well, we know that they're not, so I would like to move these amendments tabled in my name.

The question is that amendment 21 be agreed to. Does any Member object? [Objection.] We proceed therefore to a vote on amendment 21. Open the vote. Close the vote. For 23, no abstentions, 28 against. Therefore, amendment 21 is not agreed.

Amendment 21: For: 23, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 22.

Angela Burns, is it being moved?

Amendment 22 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Yes.

The question is that amendment 22 to be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 22, tabled in the name of Angela Burns. Open the vote. Close the vote. In favour 23, no abstentions, 27 against. Therefore, amendment 22 is not agreed.

Amendment 22: For: 23, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 2: Duty to secure quality in health services—meaning of ‘quality’ (Amendments 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71)

The next group of amendments is the group that relates to the duty to secure quality in health services and the meaning of quality. The lead amendment in this group is amendment 60, and I call on Rhun ap Iorwerth to move and speak to the lead amendment and to speak to the other amendments in the group. Rhun ap Iorwerth.

Amendment 60 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Thank you, Llywydd. I would assume that these amendments are quite central to what we're discussing here today. This is a Bill that relates to quality within health and social care, and these are amendments defining exactly what we mean by quality and what we mean by the standards that we expect within our services here in Wales. There are amendments here related to prevention of ill health, there are amendments related to reducing health inequalities, and also amendments on the need to provide accessible health services through the medium of Welsh, because we believe, in those three areas, we do need very real quality, and we need high standards in what we should expect. I expect the Minister to reply to this debate by saying that standards in health and care already take account of these issues. So, let's look at some of those.
Standard 1.1, first of all, refers to preventative behaviour and deals with health inequalities, and it states that:
'People are empowered and supported to take responsibility for their own health and wellbeing and carers of individuals who are unable to manage their own health and wellbeing are supported. Health services work in partnership with others to protect and improve the health and wellbeing of people and reduce health inequalities.'
Now, I don't feel that that, in and of itself, is always delivered. We may need to go further than that.
When it comes to the Welsh language, there is no particular section related to the Welsh language. What we have is a mention of the Welsh language in other parts of the standards. Standard 2.7, for example, is related to the safeguarding of children and adults at risk, and it says this:
'Priority is given to providing services that enable children and vulnerable adults to express themselves and to be cared for through the medium of the Welsh language because their care and treatment can suffer when they are not treated in their own language.'
There is also reference to the Welsh language in the standards as a means of providing equal access to everyone to services, stating that people should see that respect is shown to their cultural identity, and that they should be able to access Welsh language services without any barriers, although not everyone responsible for providing the care would be able to converse through the medium of Welsh.
But these are standards that have been in place since 2015, and I don't think that anyone could argue that every NHS institution is delivering those kinds of standards and that quality of service. I think failing to include a section specifically on the Welsh language suggests that it's not really thought of as particularly important in terms of quality, of the standards that should be expected by people. It feels like something that has been bolted on at the end.

Rhun ap Iorwerth AC: So, we reject the notion that the current standards are sufficient and we would consider all of those three categories that I've mentioned—prevention, reduction of inequalities, and the Welsh language—to be important enough to place on the face of the Bill. The Minister has already conceded that safety, effectiveness and the experience should be on the face of the Bill as part of what quality supposedly means, despite the health and care standards also referencing those too. He has defined some new things he wants to emphasise by bringing them on to the face of the Bill. Why not prevention, reduction of inequalities, and the Welsh language? We see no reason why other important factors in the quality of a service shouldn't also be on the face of the Bill. It allows for a clearer signal to be sent about what the Welsh Government considers important.
The other question to ask is that if all these important indicators of quality are already part of the health and care standards then why the need for this legislation at all? Isn't quality already part of legislation underpinning the NHS? If the answer to that is that the standards are inadequate for the Minister to enforce on health boards, then what we need is either the strengthening of the current guidance on standards, or for standards perceived to be important and not currently being met to be put on the face of the Bill. So, either the standards are sufficient, in which case there's no need for the Bill, or they're not, and we need this Bill. If they're not, then this Bill needs to have a far stronger section on defining what quality is. So, I ask you to support these amendments. Diolch yn fawr iawn.

Angela Burns AC: The Welsh Conservatives support all of these amendments, and Rhun ap Iorwerth very neatly took my words, which were: if we don't have a definition of what quality is on the Bill in all the areas, then what is the point of the legislation? If they're already doing it, if the health boards are already doing it, then we don't need the legislation.
With the previous set of amendments that I tabled a little bit earlier, that's the whole point: health boards should be doing it. If they're not doing it—. We should be achieving this level of quality in our NHS; we're not achieving this level of quality in our NHS in all of these areas that you raise—three very important areas: the Welsh language, prevention of inequalities, and the prevention work—and it is absolutely key that we do just that. So, we support your amendments and thank you for tabling them.

Vaughan Gething AC: The elements of quality set out in the Bill are non-exhaustive and deliberately broad, as I said in the debate on the first group. It is intended that quality will align with the internationally recognised definition of quality. And, again, that is intentional, given the broad-ranging functions of NHS bodies, and I do not want to risk diluting that approach or making it cross-purposes. And it's worth remembering that equity is one of the six domains recognised in the internationally accepted definition of quality, and therefore needs to be an important component of any decisions taken to secure improvement. I therefore won't be supporting the amendments brought forward in this group.
Importantly, as Members know, the Bill already makes a significant, and in this context very relevant, amendment to section 47 of the Health and Social Care (Community Health and Standards) Act 2003. That does mean that health and care standards must be taken into account by NHS bodies when discharging their quality improvement duty, and as I've already said those standards are being updated.
The health and care standards are comprehensive and mean that NHS bodies will have to consider matters relating to workforce, improving population health, equity, and the Welsh language in discharging their duty, because these are all covered in our current standards, and will be covered in the revised ones. These will be reinforced and set out in the statutory guidance that I've already referred to.
So, whilst I understand the sentiments behind the amendments, I don't believe they're required as the Bill, because of the alignment with the standards, will ensure that those requirements are covered in a manner in which they have statutory force, but also in a manner in which they can be revised, as indeed we have done at five-yearly intervals for some time. The amendments to expand the elements of quality are therefore, in my view, unnecessary, as they are already provided for.
To summarise, in my view, all three of the areas highlighted are catered for in the health and care standards that underpin the duty of quality, and the guidance can further reinforce this. There will also be important considerations for Welsh Ministers when taking decisions with a view to securing improvement in the quality of services. I therefore ask Members to oppose the amendments in this group.

Rhun ap Iorwerth to respond to the debate.

Rhun ap Iorwerth AC: Diolch yn fawr iawn, Llywydd. I'm grateful for the signalling of support from Angela Burns and the group opposite; disappointed, but not surprised, in not gaining the support of Welsh Government and Labour Members. To me, it's clear enough that the statutory guidance that we have now isn't delivering the quality that we want as strongly as we could. It strikes me that if we're not seeking to actually enhance the quality of services through a health quality Bill, well, what on earth is the point of having a quality Bill? A cynic would suggest that this is a Bill that is meant to achieve something else, which is to get rid of the community health councils and their ability to be a thorn in the side of Welsh Government, and that it needed to be padded out with other things. But I'll leave it there.

The question is that amendment 60 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 60, in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, one abstention, 29 against. Therefore, amendment 60 is not agreed.

Amendment 60: For: 21, Against: 29, Abstain: 1
Amendment has been rejectedClick to see vote results

Is amendment 61 being moved? Rhun ap Iorwerth.

Amendment 61 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Yes, move.

The question is that amendment 61 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 61, in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, one abstention, 29 against. Therefore, amendment 61 is not agreed.

Amendment 61: For: 21, Against: 29, Abstain: 1
Amendment has been rejectedClick to see vote results

Amendment 62, Rhun ap Iorwerth.

Amendment 62 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 62 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 62. Open the vote. Close the vote. In favour 21, one abstention, 28 against. And therefore, amendment 62 is not agreed.

Amendment 62: For: 21, Against: 28, Abstain: 1
Amendment has been rejectedClick to see vote results

Amendment 23 in the name of Angela Burns is the next amendment. Is the amendment moved?

Amendment 23 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Move.

Yes, it is. Is there any objection to amendment 23? [Objection.] We therefore move to a vote on amendment 23, in the name of Angela Burns. Open the vote. Close the vote. In favour, 23, no abstentions, 27 against. Therefore, amendment 23 is not agreed.

Amendment 23: For: 23, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

The next amendment is 24. Angela Burns.

Amendment 24 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 24 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 24. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, amendment 24 is not agreed.

Amendment 24: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 25 is the next amendment. Angela Burns.

Amendment 25 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 25 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 25. Open the vote. Close the vote. In favour 23, no abstentions, 27 against. Therefore, amendment 25 is not agreed.

Amendment 25: For: 23, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 63, in the name of Rhun ap Iorwerth, is the next amendment. Is it moved?

Amendment 63 (Rhun ap Iorwerth)moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 63 be agreed to. Does any Member object? [Objection.] We move to a vote, therefore, on amendment 63. Open the vote. Close the vote. In favour 21, no abstentions, 30 against. Therefore, the amendment is not agreed.

Amendment 63: For: 21, Against: 30, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 64, Rhun ap Iorwerth.

Amendment 64 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 64 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 64. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore the amendment is not agreed.

Amendment 64: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

The next amendment is amendment 65, Rhun ap Iorwerth.

Amendment 65 (Rhun ap Iorwerth)moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 65 be agreed to. Is there any objection? [Objection.] We therefore move to a vote on amendment 65. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 65: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 26 is the next amendment, Angela Burns.

Amendment 26 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 26 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 26, in the name of Angela Burns. Open the vote. Close the vote. In favour 23, no abstentions, 28 against. Therefore, that amendment is not agreed.

Amendment 26: For: 23, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 3: Duty to secure quality in health services—power to issue guidance (Amendments 16, 17, 18)

The next group of amendments is the third group, which relates to the duty to secure quality in health services and the power to issue guidance. Amendment 16 is the lead amendment in this group. So, I call on Angela Burns to move the amendment, and to speak to the other amendments—Angela Burns.

Amendment 16 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Diolch. I formally move the amendments tabled in my name. The point of these amendments is to give the Welsh Ministers the duty to secure quality in health services through the guidance principle. They seek to support recommendation 2 of the committee, which requests that the Minister issues statutory guidance. In Stage 1 evidence, stakeholders highlighted that the Bill was simply not strong enough in setting out what that duty of quality is and how it would be measured.
These amendments have been drafted with the support of the Welsh Government and the Minister, and we're grateful to the Minister for this. They essentially say that Welsh Ministers must issue guidance to NHS bodies.Although we have tabled this, I would also be grateful if the Minister would confirm that the proposed guidance will include how the duties of local health boards, NHS trusts and special health authorities are assessed, as well as a demonstration of improved outcomes and how innovations and improvements can be implemented across Wales. It's about growing those small shoots, isn't it?
At Stage 2, I also mentioned that assessments are key planks to the duty of quality. They enable the relevant health authorities to provide us with uniform information about their quality indicators, and this is also how they move from what was criticised as an aspirational duty by the chair of the Welsh NHS Confederation management board to a very real and enforceable duty.
At Stage 2, the Minister noted that he agreed about the importance of setting out how NHS bodies can demonstrate an improved outcome as a result of taking steps to comply with the duty, and he shared the desire to see how innovations and improvements designed in one area could be spread and scaled across Wales. As I said at that Stage, we believe that getting the guidance right before the duty of quality comes into effect is essential. We're still not quite clear yet how that guidance will help health authorities to achieve the set levels of expected improvement, so again I would be grateful if the Minister would outline a little bit more detail on that guidance, especially given that he expects the guidance on the duty of quality to include the need to consider how a body works in partnership delivering services in an integrated way to secure improvements. And as we all know, partnership, co-production and collaboration are a very important part of raising the level of quality and the level of candour within our health boards. Thank you.

Caroline Jones AC: I'm also supporting the amendments in this group. If we are to have any chance of achieving the duty of quality, we must have statutory guidance in place that instructs health and social care providers on how they can go about implementing the duty of quality. Without statutory guidance, we leave it open to interpretation by the local health boards and local authorities. A duty of quality doesn't differ from region to region; it requires consistency and, therefore, we need national guidance. These amendments will ensure a single national approach.

The Minister—Vaughan Gething.

Vaughan Gething AC: Thank you, Llywydd. Following considerations at Stage 2, I have had constructive discussions with opposition Members and I am pleased that we've been able to reach a shared position with Angela Burns on this. By specifying in statutory guidance the evidence to be used and the way such evidence has been assessed, that will require NHS bodies to report openly and transparently on the actions that they are taking to secure improvements in quality outcomes. Importantly, in undertaking that assessment, NHS bodies will also be required to evidence how they are taking the health and care standards we discussed in the first two groups into account in discharging their duty of quality. That means that NHS bodies will have to consider all the matters set out in health and care standards, which includes matters relating to workforce, improving population health and equity. That will be explained in the statutory guidance. There is a point here about the statutory guidance that we're committing to produce on each area of the Bill: we want to see that co-produced in the way that we deliver it, rather than simply delivered by the Government. I am therefore happy to support all the amendments in this group in the name of Angela Burns.

Angela Burns to respond.

Angela Burns AC: Thank you very much indeed. It's sufficient to say that there are two words that bring joy to my heart. Caroline, you mentioned 'consistency', that's what we need; Minister, 'evidence', that's what we need. Thank you very much for supporting the amendments.

The question is that amendment 16 be agreed to. Does any Member object? Therefore, amendment 16 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

The next amendment is amendment 27. Angela Burns.

Angela Burns AC: Thank you very much—

Do you want to move amendment 27?

Amendment 27 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Sorry, I beg your pardon. I move. My listening Welsh isn't as good as I think it is. [Laughter.]

Moved, then.

Amendment 27. The question is that amendment 27 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 27. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. So, amendment 27 is not agreed.

Amendment 27: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 28, Angela Burns.

Amendment 28 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 28 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 28. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, amendment 28 is not agreed.

Amendment 28: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 66, Rhun ap Iorwerth.

Amendment 66 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 66 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 66. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, amendment 66 is not agreed.

Amendment 66: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 67 is the next amendment—Rhun ap Iorwerth.

Amendment 67 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 67 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 67. Open the Vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, amendment 67 is not agreed.

Amendment 67: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 68 is the next amendment, in the name of Rhun ap Iorwerth.

Amendment 68 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 68 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 68. Open the Vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 68: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

The next amendment is amendment 29, in the name of Angela Burns.

Is the amendment being moved?

Amendment 29 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

Therefore, the next vote is on amendment 29, in the name of Angela Burns. The question is that amendment 29 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 29. Open the Vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 29: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 17—Angela Burns.

Amendment 17 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 17 be agreed to. Does any Member object? Amendment 17 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

Amendment 30, Angela Burns.

Amendment 30 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 30 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 30. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 30: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 31, Angela Burns.

Amendment 31 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 31 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 31. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 31: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

The next amendment is amendment 69—Rhun ap Iorwerth.

Amendment 69 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 69 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 69. Open the vote. Close the vote. In favour 20, no abstentions, 29 against. Therefore, amendment 69 is not agreed.

Amendment 69: For: 20, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 70, Rhun ap Iorwerth.

Amendment 70 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 70 be agreed. [Objection.] We therefore proceed to a vote on amendment 70. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 70: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 71, Rhun ap Iorwerth.

Amendment 71 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 71 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 71. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 71: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

The next amendments is in the name of Angela Burns—amendment 32.

Amendment 32 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 32 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 32. Open the vote. Close the vote. In favour 21, one abstention, 28 against. Therefore, the amendment is not agreed.

Amendment 32: For: 21, Against: 28, Abstain: 1
Amendment has been rejectedClick to see vote results

The next amendment is amendment 18—Angela Burns.

Amendment 18 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 18 be agreed. Does any Member object? Therefore, amendment 18 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

Amendment 33, Angela Burns.

Amendment 33 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 33 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 33. Open the vote. Close the vote. In favour 21, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 33: For: 21, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

The next amendment is amendment 34—Angela Burns.

Amendment 34 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally.

The question is that amendment 34 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 34. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore that amendment is not agreed.

Amendment 34: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 4: Duty to secure quality in health services—non-compliance (Amendment 35)

The next group is the fourth group of amendments, which relates to non-compliance with the duty to secure quality in health services. Amendment 35 is the only amendment in this group, and I call on Angela Burns to move the amendment.

Amendment 35 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Thank you, Presiding Officer. I formally move amendment 35, tabled in my name. Members, I want teeth, not for me but for the NHS, and amendment 35 is tabled in support of committee recommendation 6, which asks the Minister to make a specific provision for the consequences of non-compliance with the duty of quality. I've re-tabled this from Stage 2 because, actually, I think it's vitally important that if we have legislation, it must have checks and balances built within it and the whole point of this is to give the Government, give the whole system, those very, very important teeth.
It's not intended to have a detrimental impact on the financial position of health boards, trusts or special authorities, but it could be dealt with through the NHS escalation and intervention arrangements by the health Minister. During evidence sessions and the committee's consultation, it was clear that many stakeholders wanted to introduce consequences for the non-compliance in relation to both the duties of quality and candour. The British Medical Association noted that this needed to be addressed, stating,
'Unless some form of sanction or corrective action is triggered, we believe that the proposed duty would run the risk of lacking effectiveness, and at worst would become a mere box-ticking exercise.'
The Royal College of Nursing noted that there
'has to be a consequence to doing it or not doing it, otherwise there's no incentive to do it, in a sense, at the most basic level.'
Minister, your response at Stage 2 didn't give me any reassurance in the slightest. You said, again, in your commentary from Stage 1, that there were existing mechanisms, including escalation measures, that would underpin the failure to adhere to that duty of quality. Furthermore, you went on to say that these arrangements were part of wider governance and accountability within the NHS, and you believe that it provided opportunities for scrutiny and appropriate, timely action and learning.
Well, I'm sorry, Minister, but I don't believe we are using these mechanisms and I don't believe they've provided opportunities for timely action and learning. I don't see health boards acting really quickly or learning their lessons. So, for example, we're still dealing with the fallout from some of our worst situations: Tawel Fan, where Betsi Cadwaladr is still in special measures four and a half years later, meaning that special measures and direct Government intervention haven't had much effect on the board's governance arrangements. An independent review of its psychological therapy services—you know, mental health services—highlighted that it is still failing in many areas. So, you would have thought that, after Tawel Fan, they would have actually looked at that quality in that element of the health services.
I don't really want to dwell too much on Cwm Taf Morgannwg's maternity services, but we've got to say it here. This is the truth: despite numerous reports between 2010 and 2018 stating that the board's maternity services at Prince Charles Hospital and Royal Glamorgan Hospital were in trouble, including a damning internal report by a consultant midwife, who said there were systemic failings, they were ignored by senior management. So, where's that duty to secure quality in health services? This is a direct mirror of what we've seen at Betsi.
So, Minister, members of the governing party, I really want you to think about this. This could be a really useful piece of legislation to drive quality, to drive candour through the NHS, but it has to have some teeth, and this whole amendment is about giving those teeth to the whole Act in order to ensure that we do get that real compliance. We can't afford for our NHS to carry on in a way where we cannot hold people to account and actually make sure that there are improvements. Duty to secure quality, non-compliance, give us teeth.

Rhun ap Iorwerth AC: Very briefly, just to endorse that. Any legislation needs to have teeth and we need to ensure that the legislation does have force, as Angela Burns has said.We will be supporting this amendment, and we will be arguing that it would be meaningless to pass legislation unless there are implications when someone contravenes that legislation.

Vaughan Gething AC: I will clearly expect all NHS bodies to demonstrate how they comply with the new quality duty in an open and transparent way. The new annual report will be a key vehicle for evidencing this. The amendments that we have just passed, 16, 17 and 18, will set that requirement out very clearly. This, along with other mechanisms, such as integrated medium-term plans, provides that range of opportunities to assess how the duty is being discharged.
Our existing NHS escalation and intervention arrangements should be seen within a wider governance and accountability framework within the NHS at both individual body and system levels through the quality and safety committees, the quality and delivery meetings, and joint executive meetings between the chief executive of NHS Wales and the chief executives of health boards and trusts and their senior teams. These all provide opportunities for scrutiny and appropriate timely action and learning.
I also expect HIW to take a close interest in how an organisation is discharging its duty as part of its inspection and review work. I've already stated, and am happy to state again for the record, that there are a range of levers that may be used where a body is not exercising its functions properly and these include the escalation and intervention arrangements.
The amendment provides that Welsh Ministers 'may' issue an intervention order if an NHS body has failed to exercise its functions in accordance with the duty of quality. The circumstances in which the Welsh Ministers may issue an intervention order are already set out within the National Health Service (Wales) Act 2006. This includes where an NHS body is not performing one or more of its functions adequately. It is therefore unnecessary to add the provisions in these amendments to the face of the Bill, and I ask Members to oppose them.

Angela Burns i ymateb.

Angela Burns AC: Thank you, Llywydd. Failure to comply with the duty to secure quality in health services—you're absolutely right; it does say that
'sections 12A, 20A and 24A, they may make an intervention order in respect of the body.'
However, you've made escalation orders across our health boards because of failures in quality of care: Tawel Fan, Cwm Taf to name but two; there are other— smaller, thankfully—instances. The whole point of this is about giving a driver, it's about putting the focus on it, it's about ensuring that, when people are under pressure, they really realise, with absolute clarity, what—

Helen Mary Jones AC: Would you take an intervention, Angela?

Angela Burns AC: Absolutely. Of course I will.

Helen Mary Jones AC: I'm very grateful to you. Do you agree with me that, if we persist in passing laws in this place where there are no clear consequences on the face of the law for the people who break the law, we risk bringing the whole democratic institution into disrepute? I, for one, am sick and tired of being asked to vote for legislation where nothing happens to somebody who breaks those laws.

Angela Burns AC: I don't think I need to say any more, Llywydd, because I think Helen Mary has absolutely encapsulated my entire feeling on it, which is why we brought this amendment. We've got to up our game. The whole point of this legislation is about us upping our game, and making sure that those who run our health boards, the management teams, really make sure that providing quality care to our NHS citizens, the people who use our NHS, is actually one of their primary jobs, not an also-ran. Members, I really ask you to think about this hard and to support our amendment.

The question is that amendment 35 be agreed to. Does any Member object? [Objection.] Therefore, we proceed to a vote on amendment 35. Open the vote. Close the vote. In favour 23, no abstentions and 28 against. Therefore, the amendment is not agreed.

Amendment 35: For: 23, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 5: Duty to secure quality in health services—data (Amendment 38)

The next group is group 5, which relates to the duty to secure quality in health services and data. Amendment 38 is the only amendment in the group, and I call on Angela Burns to move and speak to that amendment. Angela Burns.

Amendment 38 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Thank you, Presiding Officer. I've been an Assembly Member for about 10 years now, and I've sat on a whole variety of committees—finance, health, education, children and young people, as it was—and all the time we talk about 'How do we know?' How do we know that we're performing well? How do we know that we're meeting our targets? How do we know we're delivering the outcomes for the money that we're spending? This amendment, amendment 38, which I formally move, is about getting the data so we have the information so we can make the planning.
It is an amendment that was based on a suggestion by the Royal College of Surgeons in their written evidence to the committee, but it actually runs true throughout the whole of the objective of this Bill. We want to know how well our surgical outcomes data is doing at a unit level. Again, I want to remind Members of another exciting fact: how many times have any of you—and maybe not you, but I'm sure Members of Plaid Cymru and I'm sure Members of the Brexit Party, I know Members of my party and I'm sure some of the independent Members will have put in freedom of information requests to try to drill down to get that information to find out what happened: where; when; how? How many things have been achieved; how many operations have happened; what type of operations; where are the blockages? Because by knowing what is going on, by having that data, you can actually start to have good governance. You can go back, you can challenge and you can scrutinise. This amendment is all about getting good data.
I listened, Minister, to your response at Stage 2. You were very concerned about a prescriptive list of information, and I took that on board. As a result, the amendment here at Stage 3 is broader and it's also with an inclusion that the data is shared with Ministers and Public Health Wales to help inform your future work and planning. This is about helping you and helping your NHS teams to perform better, to do a better job, to know what is going on.
I was very disappointed by your response to the Chair of the Health, Social Care and Sport Committee. It's not good enough to list off the current indicators by which health boards must measure their performance. I do note the work surrounding the Once for Wales concern management system on the recording of incidents, complaints and adverse outcomes in healthcare, as well as the aim to develop a single framework for measurement and benchmarking of quality-related data under the five-year quality and safety plan, but I don't think these are yet sufficient to properly analyse patient outcomes. I think it would be prescient for the National Assembly for Wales to monitor the progress of those programmes closely given the past issues we've had with data collection. I would like to remind Members that it was only recently that we found some of the data at Cwm Taf Morgannwg was completely wrong. They had mislaid I think it was 2,700 operations, appointments and results. We need efficient, good data. This Bill gives us the opportunity to do it. Please, Members, consider that and pass this amendment.

Rhun ap Iorwerth.

Rhun ap Iorwerth AC: Thank you for the opportunity just to say a couple of words. This is also an area where, if we are going to have a Bill that is worthwhile, we have to look for ways to have an impact through it. We know from experience that a lack of data is holding us back, in terms of our ability to increase quality within our health and care services. We support the amendment. We know that data, and the shortage of data, is a problem within the NHS. It is important, for me, to think that we should be getting LHBs to prove that they are complying with legislation, because, otherwise, all we’ll get is some kind of ambiguous certainty that everything is right, until we end up in a situation similar to Cwm Taf again, where we find that things are not okay. This is an opportunity to respond to that situation.

The Minister to respond, Vaughan Gething.

Vaughan Gething AC: Thank you, Llywydd. There are already many systems in place to collect, analyse and publish data across our national health service. Much of this is captured on a Wales and England basis, if not a UK-wide basis, such as the range of national clinical audits. It is what is the done with that data that is, of course, key. Amendments 16, 17 and 18 dealt with the requirement for Welsh Ministers to issue statutory guidance in relation to the quality duty and for that guidance to include the evidence for how an assessment has been made to ensure a stronger focus on using data and for that data to be reliable in enabling a body to make decisions that will ensure improvements in quality outcomes.
And, as Angela Burns knows, there is already considerable work under way to streamline and improve our data and that important things are routinely measured in a consistent and clinically relevant way. Because one size will not necessarily fit all. We have to retain some flexibility to determine and review what data is collected in the best and most effective ways, to keep pace with technology and other evidence-based requirements. For example, the changes in the clinical model adopted by the ambulance service, widely adopted in England and Scotland, have necessitated changes in data collection and the way we hold the system to account for their performance.
The work under way to implement the cancer pathway will also necessitate changes to the type of data we collect to see if we are securing improvements in the quality and delivery of the service. Our intention is to develop cancer data and intelligence in order to support better system planning and delivery. That will involve the collection, use and publication of a more comprehensive set of activity data.
And, as Angela Burns referred to, we're working with the service to finalise a five-year quality and safety plan that describes a range of high-level strategic recommendations, including a specific action around addressing measures, data and analytics. A collaborative programme of work will be established to take that plan forward, with one of the aims being to develop a national approach to measuring and benchmarking quality-related data. I expect that plan to be published ahead of summer recess within this calendar year.
NHS Wales is also in the process of implementing a new system, as referred to: the Once for Wales concerns management system for how local health boards and NHS trusts record, report, monitor, track, learn and make improvements from incidents, complaints, claims and other adverse outcomes. The aim of this is to achieve consistency of data management and workflow design in these areas, across Wales. It is intended that the new system will be implemented over the coming year.
I understand where this amendment is coming from and agree with the Member about the importance of consistent, streamlined and cohesive available data. As I have explained, work is under way on a number of fronts to achieve just that. As evidenced by some of the work in this area that I have described, I don't agree that we need further legislation to achieve this. Legislation would certainly add to bureaucracy and take away flexibility and has a real potential to slow down and even stifle innovative work in this area. I therefore cannot support the amendment.

Angela Burns to reply to the debate.

Angela Burns AC: Thank you for that. Some of the words that I find the most slippery are words like 'intend' and 'expect', because they don't actually tell you when you're going to do something and how you're going to do it.
So, let me just remind Members: in July 2013—we're now in 2020—so, seven years ago, the Welsh Government said it would work to publish—in fact, you didn't just say it, you announced that you would work to publish surgical outcomes data in Wales at a unit level, with a promise to consider individual outcomes data at a later date. It's not been progressed; it's not been achieved. This amendment is intended to drive your Welsh Government promises forward and to remind the Minister that we've already asked to make this an urgent priority, as has already happened in NHS England.
Why is that important? Because if you knew what was happening, for example, with operations, how many are cancelled and whether that cancellation is for a clinical or non-clinical reason, from the health board and from the patient—. We have a little bit of that data, but simply not enough to understand where the pressures are or what is contributing to long waiting times, what is contributing to the bottle necks, and how we can resolve it. Seven years—still not delivered. I'm not holding my breath. If this doesn't get passed, I'm not holding my breath that we will see that data brought forward in a really timely manner, where it is useful to help us to frame or reframe the way we work in our NHS.

The question is that amendment 38 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 38. Open the vote. Close the vote. In favour 23, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 38: For: 23, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 6: Duty to secure quality in health services—register of managers (Amendment 72)

The next group of amendments is group 6, which relates to the duty to secure quality in health services and a register of managers. Amendment 72 is the only amendment in this group. I call on Rhun ap Iorwerth to move that amendment.

Amendment 72 (Rhun ap Iorwerth, supported by Caroline Jones) moved.

Rhun ap Iorwerth AC: Thank you very much. I do urge you to support this amendment. Should we be able to expect, or should we hope to have, the clinical staff, the best possible doctors, nurses and so on, within the NHS? I think we should, and there are systems in place to ensure that standards are maintained. Should we expect and hope to have the best possible managers within the NHS? Yes, I would argue that we should, but we don't have the same systems in place to try to maintain those standards.
What this amendment does is to create a register of NHS managers and a body with oversight of that register. We have made some changes since Stage 2 proceedings in order to ensure that that oversight body does have the ability to put competencies in place and to place sanctions on managers who fail to reach certain standards.
In the case of nurses, doctors, midwives and other health professionals, there are regulatory bodies in place that insist on high standards, which have the ability to discipline staff if they fail to attain those standards, to put things right when standards are not attained, where there is negligence, and then it's possible to prosecute in accordance with those regulatory standards. But among managers, we don't have those arrangements in place that would ensure that we should insist on a particular standard. We have excellent managers within our health service in Wales, at all levels. We need to give those managers within the NHS pride. We need to celebrate good management. But if we do that on the one hand, then on the other hand we need to ensure that we have those tools in place and that we have systems that provide a yardstick, where we can say, 'Yes, this is the expected standard.'
As we know, we have had too many experiences within the NHS in Wales over the years where managers have fallen way below the standards that we should expect of them. There are grave implications where managerial errors and mistakes have been made. And very often, we will see a manager moved on and taking another role in a health board without there having been processes followed, either to correct, to penalise or to bring sanctions into play, but mainly in order to improve standards.
I understand that some preparation has been made in terms of the kind of system that we are suggesting here, and that this is something that the Government realises should be addressed, but, for some reason, there is an unwillingness, or there has been an unwillingness, to say, 'Well, that's enough of a throwaway attitude towards standards among managers—let us do something to correct the situation.'
I don't think that we can drive standards up to do more with less, and to use resources far more efficiently, unless we have a mechanism in place to improve management. Although the Government will reject this amendment, I fear, I do truly believe that this is an area where the Government should be focusing on, and that this should have been a core part of the Bill, if the purpose of that Bill was to raise standards within health and care.

Angela Burns AC: Thank you very much to Plaid Cymru for bringing this forward. This element of the Bill is really important. I have a stand at the moment to abstain, and the reason for this is because I want to hear what the Minister is going to say in response to you. I agree, it is vitally important to create a register of managers. It's vitally important to have sanctions and measurability on it to make sure that they are doing the job that they're employed to do properly.
And, of course, the other great thing that can happen is that by having such a register, if you move a duff manager on or out, that person is picked up by the next organisation and trained appropriately and encouraged to develop and then pop back in at the right level. Very important—it's all about not being punitive but about identifying where somebody's doing a job that perhaps could be too big for them, that they get the right training, the right support, and they move on through.
Where I'm slightly unclear is the definition of manager. Now, I've been a manager for a big chunk of my life, and I've been registered as a manager, as a director with the Institute of Directors, with the institute of marketing, the Institute of Sales Management, the institute of general management in business, so I'm just slightly unclear, and I would like to have some clarity. Because if you look through, just briefly, you've got everybody from finance managers to hospital managers, estate managers, health and safety, ward managers. So, that's why I'm just slightly in the mood, at the moment, to abstain. I want to hear what the Minister has to say, but if you want to clarify that, it'd just be really, really helpful, because I think it's such an important point.

Rhun ap Iorwerth AC: I'll certainly clarify in this way: I acknowledge that the NHS is a complex machine within which there are many layers of management. The shame, in a way, is that we are here at Stage 3, having proposed this at Stage 2, and having put this on the table at a point where Welsh Government should, and could, have engaged with it in a way, using the might of the Government machine, they would have been able to identify clearly how to implement this kind of change. But I don't think that that detracts from what we are trying to achieve here.

Caroline Jones AC: I'm backing the amendment in this group, and I agree with Plaid Cymru that there has to be a register for NHS managers. I've said many times in this Chamber that we must ensure health service managers abide by the same obligations as clinical staff. Clinicians are covered by duties of care placed upon them by their royal colleges and the various professional bodies. Managers are an essential part of our modern NHS, and they can often play a role in ensuring the quality of care provided to patients.
And I regret that Helen Mary's proposals for a NHS management Bill was rejected by the Government. I welcome the fact that this amendment seeks to address the issues highlighted by Helen Mary's proposed legislation. Managers will play a vital role in securing both a duty of quality and of candour, and we must ensure they are held to the same high standards as clinical staff. I believe registration to be the way forward and therefore support amendments 72, tabled by Rhun, and hope colleagues will follow suit. Diolch yn fawr.

The Minister to reply to the debate—Vaughan Gething.

Vaughan Gething AC: As Rhun ap Iorwerth implied, I do not support the amendment that now appears in his name. But I support the aim of ensuring that health service managers are competent and capable and that those who fail cannot just move on to another job elsewhere in the system.
I do not agree that amending this Bill to create a new corporate body and a complex and bureaucratic system of registration is the right way to do that. Of course, that isn't just my view. The health committee, in its Stage 1 report on the Bill, recommended the Government bring forward proposals in the future to address the regulatory imbalance between clinical staff and non-clinical managers, but recognised that this is not a matter for this Bill.
Just as in extending the staffing duties that we discussed earlier at all levels would not be appropriate, that is exactly the same point here. Members may want to consider the actual wording of the amendment they're asked to pass. It starts off by saying that
'Regulations must provide for the creation of a register of clinical and non-clinical managers'.
The next subsection refers to all persons:
'All persons who carry out managerial roles within or on behalf of a Local Health Board, NHS trust or Special Health Authority must be registered on the register of managers.'
And Members should consider the scale of what you're being asked to agree to. So, who is a manager? Well, a band 6 nurse, a deputy ward manager—the clue is in the title. To then say the scale of activity on band 6 upwards right across our service, so that all the clinicians call them that, who have their own professional requirements as well, and all of the non-clinical managers—we have to run a huge undertaking. And I raised this point in the Stage 2 committee debate, that creating a specific and prospective regulatory regime would need detailed financial and policy work to be considered to reflect the diverse nature of the workforce and their roles. We'd need to address the issues about the balance of responsibilities between the employer and the regulator, how any requirements apply to individuals or healthcare professionals and managers, and the mobility of the workforce, which is a key consideration for us in many parts of the national health service in Wales. The care and the thought required is simply not available to us and it is simply not the right way to try and amend this Bill, to introduce such an enormous undertaking.
Additionally, in terms of the value-for-money measures, we of course can't have any idea about what that is now, but we do understand some of the complexity of the level of bureaucracy and the demand. When we established Health Education Improvement Wales, the cost for establishing that was around £2.8 million. I couldn't tell you today what the cost of implementing and agreeing this proposal means just for the implementation stage, never mind the operational stage. It's not just the cost, of course. I've already referred to the challenge we have about the fact that managers and staff do regularly move across borders.
Now, I do want to hear the findings of the working group set up by NHS England to consider therecommendations of the Kark review, an independent review of how effective the system in England is at preventing unsuitable staff from being redeployed. That called for a central database of all NHS directors, but even within England they recognised it's complex, and something they may not be able to achieve on a single-nation basis. Now, they recognised the complexity of issues and they themselves want to have a conversation on a four-nation basis. I am more than happy to participate in a four-nation conversation about the sorts of services that I think are worth pursuing, not just for Members in this room but for the wider public. But as for the amendment before us today, it is not simply the appropriateness of dealing with it, but I think the way it's drafted makes it defective and not something that any Member should support.

Rhun ap Iorwerth to respond to the debate.

Rhun ap Iorwerth AC: Diolch yn fawr iawn. Well, the Minister very feistily explains why he won't be supporting this amendment aimed at increasing or improving standards within the NHS in Wales in a pretty fundamental way. I do believe that Government did suggest there that they would be moving their own model of regulating managers within the NHS. I don't know if the Minister wants to confirm that, if that was your intention, Minister, in referring to what was said at Stage 1 of the Bill's journey through the Assembly; possibly not. Well, that's how I read it and I do look forward to the Government addressing this in future.
We heard the Minister say that's in an enormous task. Yes, it is an enormous task. This is a task that is worth doing. It's sometimes worth rolling up your sleeves and taking on a big task because there's a job that needs to be done. He refers to the mobility of the workforce and people working across borders. We shouldn't, should we, expect England substandard staff from Wales? Well, we don't want to take substandard staff from anywhere else, so surely we should be setting our own parameters by which we expect to be able to employ our staff in order to achieve the standards that we want within the NHS. It's the job that needs to be done. I picked up a suggestion from the Minister that it's something that Government will look at in future. I hope that's true, but for the time being we're still going to be supporting our own amendment, and I ask you to too.

The question is that amendment 72 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 72 in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 72: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 7: Duty to secure quality in health services—review of statement of standards (Amendments 36, 37)

The next group of amendments is group 7, which relates to the duty to secure quality in health services and a review of statement of standards. Amendment 36 is the lead amendment in this group, and I call on Angela Burns to move that amendment and to speak to the other amendments in the group. Angela Burns.

Amendment 36 (Angela Burns) moved.

Angela Burns AC: Diolch, Llywydd. I formally move the amendments tabled in my name. These amendments consider the Minister's concerns at Stage 2 about the implications of extending safe staffing levels to all clinical staff. This is despite the Chair of the Health, Social Care and Sport Committee stating that, in the committee's view,
'it is impossible to separate out the issue of quality from the provision of appropriate staffing levels—they are inextricably linked.'
And we still firmly believe that is the case. The Minister has instead relied on the health and care standards on workforce levels, and, at Stage 3, the Minister promised to update them. To that end, amendments 36 and 37 are intended to place that promise on the face of the Bill.
Amendment 36 places a duty on Welsh Ministers to carry out a detailed review of the standards at least once every term, meaning that we will have an opportunity to, first of all, analyse how effective the standards are at ensuring safe staffing levels. I cannot impress upon the Minister enough how important it is that we have this commitment across all clinical staff since the Mid Staffs report's findings. Indeed, the Royal College of Physicians UK said that, in 2018, more than one in five of their census respondents reported that gaps in trainee rotas occurred so frequently as to cause significant problems in patient safety. It is therefore essential that workforce planning is undertaken across the board. As such, health boards need to ensure workforce levels are planned and accounted for, and not to just rely on safe staffing for nurses. Secondly, we need to be fully aware of evolving changes to NHS pressures in population age, which will increase incidences of comorbidity and complex conditions. And we also have to recognise the technological advances, which may have a further impact on staffing levels. It cannot therefore be left for five years between updates and reviews to this important document.
Amendment 37 ensures that Ministers must have regard to the views of stakeholders when updating and reviewing these standards. I do note, Minister, and you've already mentioned it tonight, that you've invited the British Medical Association Cymru and the Royal College of Nursing Wales to reviewing and updating the health care standards in the first instance. However, we believe this should be an ongoing duty, so that healthcare professionals are taken seriously throughout the review process.
It is extremely heartening, Llywydd, to see such a wide range of Welsh healthcare representatives bodies, including BMA Cymru, RCN Wales, the Royal College of GPs Wales, the Association of Medical Research Charities Wales, the RCP Wales, the Royal College of Surgeons of Edinburgh, the Royal College of Surgeons, and the Royal College of Midwives Wales, calling on the National Assembly to support amendments that ensure the duty of quality in the Bill is underpinned by guidance that includes reference to workforce planning, and that health and care standards are appropriately and regularly reviewed, and that reporting by NHS bodies of the steps taken to comply with the duty of quality includes workforce planning. I therefore urge all Members to support these amendments.

Rhun ap Iorwerth AC: In all seriousness, we will be supporting these amendments. This is our insurance policy after failing to have our amendments passed in group 2. I reminded you earlier that I was concerned that there were a number of standards that I'd like to see on the face of the Bill that are not there, and that that is in the context of guidance that is five years old by now. If the guidelines are going to be valuable, then we have to ensure that those guidelines are contemporary and up to date. And, in failing to have that strengthened on the face of the Bill, then, certainly, we want to see the commitment to have standards that are up to date and meet requirements that constantly change in our health and care services.

I call the Minister to reply to the debate—Vaughan Gething.

Vaughan Gething AC: I don't support the amendments, as I believe they're unnecessary. The existing legislation requires the standards to be kept under review. That means they are already subject to regular review, and updated standards are published. There is clear evidence to demonstrate that that has happened. The first set of standards, under the Health and Social Care (Community Health and Standards) Act 2003, were published in 2005. They were updated in 2010 and 2015, and of course a review of the current framework is already under way in 2020. So, as you can see, the standards are already reviewed and updated each five years. The NHS does not stand still, so it stands to reason the standards must be kept under review and updated as necessary.
With regard to amendment 37, there is already a duty to consult before publishing or revising the standards. Wide stakeholder engagement and consultation has therefore been, and will remain, a fundamental part of future reviews of the standards, as is required by the Act. Part of consulting is to take the views of consultees into account. A consultation cannot be effective without doing so. The proposed change adds nothing to what is already required by legislation and a well-established process, and I ask Members not to support the amendments.

Angela Burns to reply to the debate.

Angela Burns AC: Thank you, Presiding Officer. All I will say is I totally disagree with the Minister. As I outlined, there's so much that's going on in the NHS, there are so many advances, there are so many changes in the patient profile, we need our standards to be operated on a very, very regular basis. And, once again, I will remind everyone that we're always talking about listening to the clinicians, doing what they think is the best, taking on their advice. And I read out at the end of my first contribution a list of organisations that support this amendment, and I suggest that all Members should listen to them.

The question is that amendment 36 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 36. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 36: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 37, Angela Burns.

Amendment 37 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 37 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 37. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 37: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 8: Duty of candour—non-compliance (Amendments 39, 73, 74)

Group 8 is the next group of amendments, and they relate to non-compliance with the duty of candour. Amendment 39 is the lead amendment in the group, and I call on Angela Burns to move the amendment and the group. Angela Burns.

Amendment 39 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Diolch, Llywydd. I'd like to formally move amendment 39, tabled in my name. This amendment, 39, is in line with recommendation 9 of the Health, Social Care and Sport Committee at Stage 1, which recommended that the Minister makes specific provision for the consequences of non-compliance with the duty of candour—with the duty of honesty, integrity, truth. This was tabled by the previous Plaid Cymru spokesman at Stage 2, and we supported the intentions of the amendment then. Stakeholders were very clear that legislation alone will not change the culture of the NHS. This is what this Bill is all about—changing that culture, underpinning it, driving it forward. So, it's imperative there's a mechanism within the legislation to change that at the very top of our NHS bodies.
Going back to the failings we saw at Cwm Taf's maternity services, there was a culture of secrecy, with horrific reports of failings being ignored by senior management. It's a culture shift we need, from the very top, which is what the Minister's aiming for, and I completely support him in that drive. But that's why the duty of candour must have teeth. People have got to know that, if they can't be bothered, if they choose to lie, or if they choose to be evasive, or if they choose to just be in complete denial, or they choose not to act on something, then they will be found out, and they will have to answer for it: end of the conversation. I am brought back to the evidencesubmitted by board of the CHCs, in which they said the dutymust include recognising the key role organisational leaders have in setting the right tone and acting swiftly and decisively when things go wrong. And the Welsh Government will need to give sufficient attention to leadership development and the responsibility and accountability of senior managers in the NHS.
The NHS Confederation—they are the representative body for these health boards, but they said that the absence of any sanctions suggested the new duty of candour may achieve little over and above the duties that NHS Wales organisations and healthcare professionals are already subject to. Let me just say that again: that was the NHS Confederation, and they said that. So, that is sort of the poacher turned gamekeeper, or the other way around—I mean, if they say it, we should listen to it.
I disagree with the Minister's protestations at Stage 2 when he said,
'taking a punitive approach to try to change culture and behaviour, where you want more openness and transparency, is unlikely to achieve all the results that we would all want to see.'
And, actually, I think it's because there has been no clarity over who's responsibility it is for failings that, to be frank, buck passing has become absolutely routine in the Welsh NHS, and ignorance should not be a defence.
We would support amendments 73 and 74, tabled in the name of Rhun ap Iorwerth, as I can see the compromise struck here, and I agree with the sentiment behind reporting serious breaches to Ministers and to the Assembly. We're approaching this from a slightly different angle, but both Plaid Cymru and the Welsh Conservatives want to achieve the same aim here. I would be grateful, though, if the Member would detail what constitutes a serious breach under the amendments, just in the discussion. So, is that an adverse patient outcome, or a systemic failing like we saw at Cwm Taf?

Rhun ap Iorwerth AC: In this group, amendments 73, 74 and our amendments—they specify that breaches of the duty of candour should be reported to Welsh Ministers, who, in turn, would have a requirement to report these breaches to the National Assembly, either via an annual report, or, when the Minister deems them serious, then immediately. I would say that that level of seriousness would be defined through guidance.
Once again, I think the reason for these amendments—both ours and the Conservatives'—is about ensuring that we start to pass meaningful legislation in this place. Meaningful in the sense that there are consequences to breaking the law—something that we've already touched on earlier this evening. The arguments made against these amendments at Stage 2 were that the Minister didn't want to encourage a culture of punishment, as he feared that would deter reporting. But, of course, it's important to point out that reporting mistakes isn't a breach of the duty of candour—it's what the duty is supposed to be about. A breach of the duty of candour is the failure to report mistakes. So, discovering a breach is already effectively discovering an incident of dishonesty, therefore is surely already serious enough to warrant reporting to Welsh Government. We don't want to be too prescriptive and say that it will definitely result in punishment, but we do feel that breaching this duty is serious enough that we need to know about it. That's vital, we believe, in order to build the kind of trust that we want within health and care in Wales.
So, these amendments would place a requirement to report these breaches to the National Assembly, either via an annual report or, as I said, if the Minister deems them serious, then immediately. But it's about, as we've heard already, teeth being given to this piece of legislation and ensuring that it actually acts in a way that means we see change and an improvement to the current situation.

The Minister, Vaughan Gething.

Vaughan Gething AC: Thank you, Llywydd. I have listened to the rationale for laying the amendments tabled in this group, both at Stage 2 and again today. In relation to amendment 39, which, for reasons that I'll explain again, I don't agree with, the purpose and the effect is quite clear: any failure by an NHS body to comply with the duty of candour procedure regulations, or with the provisions is sections 5 to 10 in the Bill, must be dealt with under NHS Wales's escalation and intervention arrangements. Now, there is a recognition that there are those arrangements in place already. But there's a technical point, though, about the fact that the escalation and intervention arrangements and their use in primary legislation means there's a mixture of legislative and non-legislative measures available to the Welsh Ministers.
However, those very much, as I say, work within a wider governance and accountability framework within the NHS at individual body and system level, through quality and safety committees, on health boards and trusts, quality and delivery meetings, and joint executive meetings. Those are all opportunities for scrutiny and appropriate and timely action and learning.
Should serious concerns emerge from those mechanisms, they would, where needed, inform any discussions and potential action under our existing escalation and intervention arrangements. However, it is my expectation that every opportunity should be taken to address concerns as they emerge and that a body should take immediate corrective action. I don't believe it's necessary to include a provision on the face of the Bill that essentially says failures by an NHS body to comply with the duty must be dealt with under the measures that already exist.
I've listened again to the intended purpose and effect of amendments 73 and 74 and their requirement for Welsh Ministers to set out the procedure in regulations that NHS bodies must follow if they fail to follow the duty of candour procedure or comply with the reporting and other arrangements set out in sections 5 to 10 of the Bill. So, that means there would be a procedure for failure to comply with the procedure, and a duty to make statements and issue a report where the NHS has failed to comply with their reporting requirements. Now, that sounds really quite bureaucratic to me and adds unnecessary layers of complexity to the operation of the duty, which is not desirable. I also have real concerns about how this would work, or rather wouldn't work, in practice.
The requirement in subsection (4) of amendment 73 for Welsh Ministers to make a statement on serious breaches of the duty of candour procedure could result in information that enables patients to be identified being disclosed. The definition of a serious breach is not clear, and it's certainly not defined in the amendment. Requiring Welsh Ministers to report on the number of the breaches of the duty of candour that are reported to them is, again, unnecessary. In terms of monitoring compliance with the duty, I expect regular updates to be provided in public safety and quality committee meetings so independent members, as a first port of call, can seek assurance that the duty is being discharged and learning being taken forward.
Now, that will be discussed at quality and delivery group meetings between Welsh Government, individual bodies, joint executive team meetings, and of course between the chief executive of NHS Wales and the chief executives of boards and trusts, as well as my appraisals with chairs and vice-chairs. The Welsh Government will also monitor the content of those reports alongside other sources of information to help us try and get at the application of the duty with, for example, consideration of serious incident reports. The reports will also be considered by Health Inspectorate Wales as part of their wider reviews of services. Where concerns come to light through these mechanisms, they would undoubtedly inform the tripartite discussions and any subsequent advice to Ministers on escalation and intervention.
But I do need to return back to a point that was made both at Stage 2 and in the previous two contributions: the key intention of the duty is to promote an ethos of learning and improving and the promotion of an open and honest culture to be owned at an organisational level. When comments are made about how there's already been an act of dishonesty or lying if the duty is breached, I don't think that sets the right tone at all. It would be possible for an oversight or a mistake to lead to a breach of the duty, not an act of deliberate dishonesty, necessarily. And that runs wholly against our aim to foster that open culture, where people can hold their hand up when something goes wrong, rather than looking to say, 'How can I explain this away or avoid responsibility?'
The approach that is being urged on us in these amendments is, in my view, entirely the wrong approach to take. And in any event, the powers to intervene already exist. I don't believe that these overly bureaucratic amendments would facilitate the creation of the open and honest ethos that we're aiming to create. More concerning, though, is that they really could drive a much more punitive culture and a fear of reporting. I ask Members to reject the amendments in this group.

Angela Burns AC: I honestly don't think I could disagree with you more, actually, Minister. Many years ago, I worked for a very wise business leader who said that he would never sack me for making a mistake, but he would sack me for failing to own it; and this is what we have here. Just let me remind you where we're at, because these are the last amendments to this Bill that are about the duty of quality and the duty of candour. Now, the whole premise of this entire Bill is about driving up the quality standards and about making our NHS more open and transparent. We have more amendments to come, but they're all about the citizen voice body and some technical stuff, basically. So, these are the two main strands: we want an honest and open culture, a culture where, when a staff nurse or midwife does a report that says that there are serious failings in maternity services, she or he would feel empowered to be able to flag that up because that's a duty of candour, and it's representing a duty of quality.
So, what is about to be passed—because I'm sure you'll end up, because you've been whipped, voting this amendment down—is a Bill that is going to actually say something along the lines of, 'Please be candid, but if you're not, if you deliberately decide not to be, then never mind.' And that's what we're trying to do here. We may not have done it in the best way. You used the word 'punitive', and you've used it a couple of times tonight. This isn't about punishment, but it is about saying, 'Please be honest. If you're honest: absolutely fine. If you own it: absolutely fine.' That's what the patient wants, the odd 'Sorry' every now and again. That's what we want to hear, 'We screwed up on this, we need to do it differently', not hiding it. We've got too many instances where it's deliberately being hidden or there's deliberate vagueness, and it's just not being changed. So, well done, great Bill, great bit of legislation, but it's going to do very little to actually drive that culture change.
We've all talked about it, time and time again, about being the best, about Wales having the leading NHS, the best social care, the best of everything, being the first with new and groundbreaking legislation. With this, all we're saying is, give it some teeth, so that if you are a senior manager and you see something and you choose to stick it in your bottom drawer and say nothing about it you will know that, eventually, when you are found out there will be consequences. Please vote for these amendments.

The question is that amendment 39 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 39. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 39: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 73, in the name of Rhun ap Iorwerth, is next.

Amendment 73 (Rhun ap Iorwerth, supported by Caroline Jones) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 73 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 73. Open the vote. Close the vote. In favour 22, no abstentions, 27 against. Therefore, the amendment is not agreed.

Amendment 73: For: 22, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 74, Rhun ap Iorwerth.

Amendment 74 (Rhun ap Iorwerth, supported by Caroline Jones) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 74 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 74. Open the vote. Close the vote. In favour 22, no abstentions, 26 against. Therefore, the amendment is not agreed.

Amendment 74: For: 22, Against: 26, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 9: Citizen Voice Body—members (Amendments 5, 48, 6, 7, 8, 49, 9, 50, 51, 52, 10, 53, 11, 12, 54, 56, 14)

Group 9 is the next group of amendments, and that relates to members of the citizen voice body. Amendment 5 is the main amendment in the group, and I call on the Minister to move and speak to the lead amendment, and to speak to the other amendments in the group. Vaughan Gething.

Amendment 5 (Vaughan Gething) moved.

Vaughan Gething AC: Thank you. I'll speak first to the Government amendments that I move, and then turn to consider the other amendments that have been listed in this group.
The Bill as introduced did not include provisions for the chief executive of the citizen voice body to be a board member. That was questioned during the scrutiny process by the board of CHCs, and I'm grateful to them for raising the matter. As the chief executive of the body will be its accounting officer, it is appropriate that the chief executive should be a member of the board. So, I'm therefore pleased to move this group of amendments that make the chief executive a board member and make consequential changes to reflect the fact that the board will now have a combination of one chief executive and six to eight non-executive members, plus a chair and deputy chair.
The Government amendments also make provision for the non-executive members of the body to invite any unions it has recognised to nominate an eligible candidate for appointment as the body's trade union associate member. A candidate is eligible for appointment if he or she is: a member of staff of the citizen voice body and a member of a trade union recognised by the body. Their role will be to provide advice to the board to ensure that workforce experience informs board discussion, activity and action. The aim is to strengthen the board connection with staff and improve the governance and service delivery of the body. The trade union member will have an advisory role, as opposed to a voting role. These are amendments that will strengthen the board leadership and governance and I ask Members to accept them.
I'll now deal with the non-Government amendments. The amendments keep the original membership structure set out in the Bill, but give the National Assembly for Wales the function of appointing the board of the body and performing functions such as approval of terms and conditions of the body's staff. I have made my position on appointment by the Assembly clear during Stages 1 and 2. The Welsh Ministers' appointment of the board members will be subject to the rules of the Commissioner for Public Appointments. That guarantees fair and open competition for the posts. I have already indicated that I am more than happy to include a stakeholder stage in the appointments process. In addition, as Members should be aware, the relevant National Assembly for Wales subject committee carries out pre-appointment scrutiny for certain chair appointments. I've already agreed that the appointment of the chair of the citizen voice body will be subject to that additional level of scrutiny by Members in this place.
The community health councils themselves said in their evidence that the new arrangement was significantly more independent than the current CHC model, and we should not lose sight of this. In the opening comments that were made, it was said that this was about taking away the independence of CHCs. For from it: it significantly strengthens their independence. As Members may be aware, there are numerous examples of bodies whose boards are appointed by Welsh Ministers, for example, Social Care Wales and Qualifications Wales. As everyone will know, the fact the Welsh Ministers appoint people to the boards of public bodies does not prevent those bodies from questioning or criticising the Government when they believe it is right to do so. The experience shows that ministerial appointment does not in any way stifle the voice of the body or inhibit its actions.
The Bill requires the body to lay a copy of its annual report before the National Assembly for Wales, which, of course, will soon be known by a different name. This was included precisely so that the annual report would be brought to the attention of Assembly Members. The Assembly will therefore have every opportunity to scrutinise the work of the body, and I fully expect the Assembly to debate the contents of the report. Therefore, I won't be supporting the non-Government amendments in this group.

Angela Burns to respond.

Angela Burns AC: Thank you, Presiding Officer. What a surprise. I mean, let's be honest, we've now come to the heart of this bit of legislation in terms of the citizen voice body. Our current community health councils are extraordinary organisations. Some of them are absolutely outstanding in the work that they do. Some of them have gone out there and uncovered real problems, brought them to light, had them addressed, and sorted them out.
So, this next slew of amendments that run—where are we? I think we're on group 9—through to almost 20 are all about the citizen voice body: how it's going to operate; how it's going to be perceived by the public. And I want to remind you, before we get into the detail of these amendments, that the citizen voice body is for the people. And in the parliamentary review—which the Minister likes to remind us on an often basis we all collegiately said we would have a look at and sign up to—it was really crystal clear that, going forward, our health service would really involve people in the provision of the health service. That they would shape it; that they would help to decide the direction of travel; that they would have input; and that, going forward, their voices would really be heard.
So, how do you hear their voice? Do you hear their voice through a chief executive of a health board? I don't think so, not really. Do you hear their voice through Assembly Members who come here and raise individual cases? Yes, for sure, we all do it. We all do it for all of our constituents, wherever we are. Do you hear it through any other organisations? Not a lot. Occasionally, you get some of the professional colleges getting involved in a particular issue. You mainly hear it through the citizen voice body, or what will become the citizen voice body.
So, we've brought these amendments—amendments 48, 54 and 56—back before you again; we tabled them at Stage 2. Because it's not just the reality of independence we need to see here, but we have to affirm the public's perception of independence. I said this at Stage 2, and I'm going to say it again and remind the Minister, and it was a comment by the ombudsman who, actually, I have come to really respect for the work that he does for the people of Wales in that role as ombudsman, he said that without independence,
'there will be this perception that it's perhaps poodle-like for some; they won't have the teeth.'
And I couldn't agree more. I'm disappointed, Minister, that you've re-tabled your amendments for Stage 2—now numbered 5, 12 and 14. It was noted at Stage 2 that there isn't much to say that the public appointments process would be more suitable for the body's independence. Rather, using the Assembly as a way of guaranteeing independent members who'd be able to challenge the Minister and health boards without fear of recrimination or loss of office.
I asked the Minister several questions on independence at Stage 2, which I don't think have been sufficiently answered by the public appointments process, and especially when, here in Wales, we have a very small pool of people to choose from; people who are very often connected in other non-governmental organisation, third sector or governmental roles. You know, it's not something to be embarrassed about; it's a fact of life, we have to face it and make sure that we put the right processes in place to make sure that the citizen voice body has, as a chair, a totally independent person.
So, Minister, I note that you claim your approach offers safeguards, but I just don't believe it, and I would ask Members to seriously think about this. This is the voice of the citizen. This is their one and only place where they can really hold us, the health boards, the Minister, the whole of the NHS, to account. We must let them be independent. Please pass these amendments 48, 54 and 56.

Rhun ap Iorwerth AC: These are very important amendments. We will be voting against the Government amendments, because that is necessary in order to have a vote on the other amendments in the group. Our view on this has been consistent throughout the discussion of this legislation. We believe quite simply that the citizen voice body should be appointed by the National Assembly for Wales and not by Welsh Ministers. The board, in reality, replaces the CHCs, and in that regard, it will play a key role in scrutinising the NHS and it is to be the patient's voice.

Rhun ap Iorwerth AC: However you want to spin it, there will always be a perceived conflict of interest when the body that is most needed to stand up for the patients—in other words, be critical, where necessary, of the running of the service—is directly appointed by the Minister. This is one of the other key reasons why we cannot support this Bill. We know, at least in parts of Wales, the community health council has been prepared to stand up for patients and be critical of the service. Look at the work being done by the CHC in the north currently in relation to decisions taken on vascular. We remain extremely concerned that the consequence of this Bill will be to remove a vitally important layer of scrutiny within our health and care system.

Caroline Jones AC: While I cannot support the lead amendment in this group, I have some sympathy with what the Minister is seeking to do. However, I believe that this place, not Welsh Ministers, is best placed to appoint members to the citizen voice body. I therefore choose to support Angela's amendments.
The citizen voice body is one of the most important parts of this legislation. I never supported replacing the community health councils, but we are where we are. It is vital that this legislation results in a body that is a true champion of patients in health and social care. I do not believe that giving Ministers the ability to hire and fire sits right with the fact that the citizen voice body will need to challenge ministerial decisions as much as those by health and social care bodies, and therefore conclude that this is a conflict of interest. An independent patient's voice body needs to be free from any perceived or actual interference from Government. That includes hiring and firing, and I therefore reject amendments 5, 7, 8, 9 and 10. We will, however, be supporting the majority of the other amendments in this group. Diolch yn fawr.

The Minister to reply to the debate—Vaughan Gething.

Vaughan Gething AC: I thank Members for their comments and I recognise that we may rehearse a number of points in the next groups of amendments.
I want to return directly to the points made about the independence or otherwise of the citizen voice body, as opposed to the current community health councils. Hearing the phrase, 'however you spin it, you can't have a body having its independence questioned', well, actually, if we look at the current group of community health councils that are being lionised by Members in this Chamber for their independence, it is worth us reflecting on the fact that they are a hosted body by Powys health board. The staff of community health councils are employees of Powys health board. We are creating a separate body where the leadership will be appointed through a public appointments process overseen by the Commissioner for Public Appointments. That is significantly more independent than the current process. Now, people may disagree with that, but to try and suggest that this somehow introduces an extra element of Government control just doesn't hold water from a logical point of view, and if you think about our current public appointments process, think about our commissioners, appointed by the Government. Well, I have never thought that any of the commissioners we have, whether the children's commissioner, the older person's commissioner or the future generations commissioner, ever felt restrained in the comments they wanted to make about the Government in public or private, and I can tell you that from a fairly long experience of dealing with people who've held all of those roles. I'm happy to take an intervention when I complete—

Angela Burns AC: I'd just like to make the point that the Welsh Conservatives have argued for a very long time that all of our commissioners should be appointed by the National Assembly for Wales.

Vaughan Gething AC: We're talking here about what happens when people argue about the appointments process at the start, and then the reality of it. Every one of those people who've held those commissioner roles have not felt constrained in their independence.

David Melding AC: There is a case to be made, and you make it strongly, but commissioners and organisations like the new citizen voice body are there on scrutiny and accountability—naturally, the legislative side, because that's our role as well as legislating, to hold the executive to account. What you are doing by having, nominally, these appointments, is putting them firmly on the executive side, at least in their formal set-up, even if that isn't their working practice, and that really isn't elegant. We should respect the division of powers and have a better structure than the one you're proposing.

Vaughan Gething AC: There's a fairly straightforward disagreement about whether the Assembly or, indeed, the Government should be the ultimate appointer of these people, but I don't accept that the practice of the way that we have run public appointments through Wales in the last 20 years, or indeed a range of posts, actually holds water for the argument that this would somehow undermine the independence of people in those roles. I'll take an intervention and then I'll complete.

Rhun ap Iorwerth AC: Just to remind you of the words that I used in my contribution—however these bodies or individuals or commissioners act, I said that there is a clear perception of a conflict of interest, and that, too, is very important when we're trying to build trust with the electorate.

Vaughan Gething AC: I think this is quite an extraordinary point. You say that there's a conflict of interest for new arrangements and an entirely separate body, but you're prepared to fight for a current position where those people are employees of the national health service. That, to me, is not a position that holds any kind of logical argument to it at all. I recognise that we don't agree in terms of the Government and opposition parties. I would ask Members to support the Government in the new process that we've introduced and to reflect the fact that the current community health council movement themselves recognise that there is significantly more independence and freedom of discretion in the Bill, as we provided in the amendments before you that I ask you to support today.

We’ll vote, therefore, on amendment 5. If amendment 5 is agreed, amendment 48 falls. If amendment 5 is not agreed, amendment 14 falls. The question is that amendment 5 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 5. Open the vote. Close the vote. In favour 28, no abstentions, 22 against. Therefore amendment 5 is agreed and amendment 48 falls.

Amendment 5: For: 28, Against: 22, Abstain: 0
Amendment has been agreedClick to see vote results

Amendment 48 fell.

Amendment 6 is the next amendment, which is to be moved by the Minister.

Formally being moved?

Amendment 6 (Vaughan Gething) moved.

Vaughan Gething AC: Yes.

Yes, it is.

The question is that amendment 6 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 65. Open the vote. Close the vote. In favour 38, no abstentions, 12 against. Therefore, amendment 6 is agreed.

Amendment 6: For: 38, Against: 12, Abstain: 0
Amendment has been agreedClick to see vote results

Amendment 7 is the next amendment. Minister.

Amendment 7 (Vaughan Gething) moved.

Vaughan Gething AC: Formally.

The question is that amendment 7 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 7. Open the vote. Close the vote. In favour 34, five abstentions, 11 against. Therefore, amendment 7 is agreed.

Amendment 7: For: 34, Against: 11, Abstain: 5
Amendment has been agreedClick to see vote results

Amendment 8, Minister.

Amendment 8 (Vaughan Gething) moved.

Vaughan Gething AC: Moved.

If amendment 8 is agreed, amendment 49 falls. The question is that amendment 8 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 8. Open the vote. Close the vote. In favour 28, no abstentions, 22 against. Therefore, amendment 8 is agreed to and amendment 49 falls.

Amendment 8: For: 28, Against: 22, Abstain: 0
Amendment has been agreedClick to see vote results

Amendment 49 fell.

Amendment 9, Minister.

Amendment 9 (Vaughan Gething) moved.

Vaughan Gething AC: Move.

If amendment 9 is agreed, amendments 50, 51 and 52 will fall. The question is that amendment 9 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 9. Open the vote. Close the vote. In favour 28, no abstentions, 22 against. Therefore amendment 9 is agreed and therefore amendments 50, 51 and 52 fall.

Amendment 9: For: 28, Against: 22, Abstain: 0
Amendment has been agreedClick to see vote results

Amendments 50, 51 and 52 fell.

We therefore move to amendment 10 in the name of the Minister.

Amendment 10 (Vaughan Gething) moved.

Vaughan Gething AC: Formally.

If amendment 10 is agreed, amendment 53 falls. The question is that amendment 10 be agreed to. Does any Member object? [Objection.] Open the vote on amendment 10. Close the vote. In favour 27, no abstentions, 21 against. Therefore, amendment 10 is agreed. Amendment 53 falls.

Amendment 10: For: 27, Against: 21, Abstain: 0
Amendment has been agreedClick to see vote results

Amendment 53 fell.

Therefore, we move to amendment 11, Minister.

Amendment 11 (Vaughan Gething) moved.

Vaughan Gething AC: Moved.

The question is that amendment 11 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 11. Open the vote. Close the vote. In favour 38, one abstention, 11 against. Therefore, amendment 11 is agreed.

Amendment 11: For: 38, Against: 11, Abstain: 1
Amendment has been agreedClick to see vote results

Amendment 12, Minister.

Amendment 12 (Vaughan Gething) moved.

Vaughan Gething AC: Formally.

The question is that amendment 12 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 12. Open the vote. Close the vote. In favour 38, one abstention, 11 against. Therefore amendment 12 is agreed.

Amendment 12: For: 38, Against: 11, Abstain: 1
Amendment has been agreedClick to see vote results

Amendment 54, Angela Burns.

Amendment 54 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 54 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 54 in the name of Angela Burns. Open the vote. Close the vote. In favour 22, no abstentions, 28 against. Therefore, the amendment is not agreed.

Amendment 54: For: 22, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 56, Angela Burns.

Amendment 56 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 56 be agreed. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 56 in the name of Angela Burns. Open the vote. Close the vote. In favour 21, no abstentions, 29 against. Therefore, the amendment is not agreed.

Amendment 56: For: 21, Against: 29, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 10: Citizen Voice Body—indemnity cover for volunteers and staff (Amendment 55)

Group 10 is the next group of amendments relating to indemnity cover for volunteers and staff of the citizen voice body. Amendment 55 is the only amendment in the group, and I call on Angela Burns to move the amendment. Angela Burns.

Amendment 55 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Thank you very much, Presiding Officer. I'd like to formally move amendment 55 concerning indemnity cover.
It is an absolute ambition, which I rightly support, that Welsh Government should increase the number of volunteers who sign up to support and to run and be part of the citizen voice body. However, we must also be prepared to protect them. Unnecessary involvement in court cases would have a devastating effect on the number of volunteers that we could attract, and it takes up a huge amount of time, and we don't want to see the citizen voice body being distracted from its main objective. I noted at Stage 2 that, currently, community health councils do have indemnity for their members, with the code of conduct stating:
'An individual CHC member who has acted honestly and in good faith will not have to meet out of his or her own personal resources any personal civil liability which is incurred in execution of purported execution of his or her CHC functions, save where the person has acted recklessly'.
Now, the chief executive of the CHC also told me that it would be essential that volunteer members acting on behalf of the new citizen voice body are properly identified, and if it is to be the responsibility of the new body to make its own arrangements to provide such cover through that indemnity insurance, then the body would need to receive adequate funding to meet the cost of this insurance. And it's our understanding that such indemnity is unlikely to be necessary for staff, as the body would normally be vicariously liable for anything done by staff in the course of their duty.
Now, I think this is a really important amendment because, from my own personal experience at Hywel Dda, I had a situation where the Hywel Dda community health council was being sued by the organisation that had put together a consultation on—sorry, I've forgotten which one, but there have been a number of different changes and different consultations out there to change the direction of travel and the formation of services within Hywel Dda. But what we had was the CHC representing its citizens and saying, 'This consultation has not been done fairly; it's not been spread out across the whole of the Hywel Dda region in an appropriately fair, balanced manner', and they were threatened with being sued by the organisation who'd put the consultation together. And I can tell you, I had CHC members coming to see me, good honest people, salt of the earth people, people who were involved, because we're always saying, 'Let's get volunteers involved', who were going, 'Oh, my god, what's going to happen? Am I going to lose everything? How can I be liable personally? I don't understand; I'm doing this on behalf of the CHC.' This is why we need to ensure we have indemnity cover for volunteers as well as staff.
At Stage 2, the Minister's response was to explain that under 'Managing Welsh Public Money' it will be up to the board of the CVB to purchase an indemnity insurance policy, or to use their own resources to indemnify volunteers. And in his letter to the Chair of the Health, Social Care and Sport Committee on 26 February, the Minister outlined that it would be up to the chief executive of the new body to decide whether to provide indemnity by bearing the risk, or through the purchase of commercial cover, and such a decision should always be made after cost-benefit analysis, in order to secure value for money under 'Managing Welsh Public Money' rules.
Now, I do accept the Minister's assertion that the appropriate mechanism for providing indemnity will be determined during the implementation phase for the citizen voice body. But as I said at Stage 2, while the CHCs have put in place procedures to rectify the issues that they encountered in 2013, it is unclear whether the CVBwill have similar procedures. And I still have concerns about the possible consequences of not having an indemnity procedure set out. And without that indemnity set out for the CVB, this could still put a great number of people off volunteering for a very, very worthy organisation. We need to be aware that indemnity protection will inevitably eat into the CVB'sbudget, and therefore we need assurances from the Minister that the Welsh Government will provide sufficient resources to be able to purchase that indemnity for volunteers and staff.

Rhun ap Iorwerth AC: Just a few words to say that we will support this amendment. I do believe that it’s crucial, if we are to attract people to give of their time to work in areas such as this, for the benefit of the public, that they have the necessary support to do that. It’s clear to us that it’s important that both staff and volunteers should have the appropriate legal cover for being involved in these activities.

Vaughan Gething AC: The amendment places a duty on Welsh Ministers to make regulations to require the citizen voice body to hold indemnity cover for the benefit of staff and volunteers. I agree that the citizen voice body should decide and plan how to organise its indemnity cover, as should any public body. However, a provision of the type that is suggested is not, in my view, appropriate, and I cannot therefore support it.
I reported to the Stage 2 committee proceedings that it will be for the citizen voice body to decide how best to indemnify staff and volunteers. And I made reference to the 'Managing Welsh Public Money' guidance, which is clear that public sector organisations do not, as a general rule, purchase commercial insurance, except where there is a legal obligation to do so. However, it does also allow accounting officers, as part of a risk management strategy, to choose to purchase commercial insurance in certain circumstances. And it is true that the citizen voice body, just as the current community health councils do, will rely on volunteers in a very different way to other public bodies. Such decisions on a risk management strategy should always be made after a cost-benefit analysis, in order to secure value for money. It will therefore be for the chief executive of the new body to decide whether to provide indemnity by bearing the risk or through the purchase of commercial cover. And I have tabled a revised regulatory impact assessment setting that out. I have given the committee the written assurance that the appropriate mechanism for providing indemnity will be determined during the implementation phase of the citizen voice body, including carrying out a cost-benefit analysis. Requiring the body in regulations to obtain indemnity cover would therefore not be appropriate, and would not reflect the principles of 'Managing Welsh Public Money'.

Angela Burns to reply.

Angela Burns AC: I just have a real problem with your rejection of this amendment, Minister. What we're asking is we are asking volunteers, people who may have some experience of dealing with large organisations, to come and volunteer for the citizen voice body, and to speak on behalf of the citizens they represent. If you were to boil it down into a different way of saying it, they are speaking truth to power. They need to be protected. And I really ask, Minister, that you change your mind. Truth to power puts you in a very vulnerable position. We're asking them to speak truth to power. They're not as big, they're not as tough, they're not necessarily as experienced as who they're speaking to. Truth to power is something that we should protect at all cost. Please vote for this amendment.

The question is that amendment 55 be agreed to. Does any Member object? [Objection.] Open the vote, therefore, on amendment 55. Close the vote. In favour 21, no abstentions, 28 against. Therefore, amendment 55 is not agreed.

Amendment 55: For: 21, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

We will have a short break of about 20 minutes, and I will ring the bell five minutes before we restart.

Plenary was suspended at 19:25.

The Assembly reconvened at 19:49, with the Llywyddin the Chair.

Group 11: Citizen Voice Body—resources (Amendments 57, 58)

We will reconvene. Group 11 is the next group for discussion. This group relates to resources for the citizen voice body. Amendment 57 is the lead amendment in the group, and I call on Angela Burns to move the lead amendment and speak to the other amendment in the group. Angela Burns.

Amendment 57 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Diolch, Llywydd. I formally move amendments 57 and 58, tabled in my name. This is about the duty to ensure sufficient resources, and the amendments seek to request that Welsh Ministers should ensure that those sufficient resources for the citizen voice body are put in place.
These amendments have been brought forward from Stage 2, as while the Minister outlined that they're putting in considerable resources for the CVB, this is to make sure that its functions and importance for the Welsh citizen are not lost or set aside in the future, and the regulatory impact assessment shows just an extra £600,000 in running costs compared to the CHCs.
I do accept the Minister's point that financial decisions have to be made carefully, and I also believe that the buck stops with the Welsh Government when they make these decisions every financial year, but this is not just about a budgetary choice; there are specific needs, including indemnity, public engagement, education and training. These are clear needs that the citizen voice body must continue in order for it to run well. It's of vital importance that the citizen voice body can carry out certain functions in order to be able to effectively scrutinise the Welsh NHS, and without a clear marker to continue this choice, we don’t have reassurance that this will happen well into the future.
The Health, Social Care and Sport Committee was clear about this at Stage 1, stating that it had shared witnesses' concerns about the level of resources allocated to the CVB, with costs associated with its establishment, work across health and social care sectors, and putting regional structures in place. Most importantly, the committee stated that it feels
'there is a weight of expectation on the new Body, particularly given its extended role to represent the public interest across the health and social care sectors. We do not believe the resource allocation is sufficient to enable it to live up to these expectations.'
As I said, the RIAdoes outline some of these costs. It remains to be seen though whether these are sufficient, and I want to remind Members of the value that stakeholders place on resourcing the body properly and why it's so important to place that commitment on record.
Social Care Wales said,
'Promoting the new Body and ensuring that the general public understands its role'
is a key priority.They said it's crucial that volunteers to the body receive sufficient training and support from the outset, as well as receiving ongoing support. In their evidence, they said they noted that understanding the implications in terms of resources of a genuinely engaged citizen voice is one that's important to make, and their representative went on to say that they,
'suspect that if the ambitions of this are achieved we will actually see an increase in activity'
and hopefully, that, of course, will require more money.
The older people's commissioner, very clearly, said that as the social care sector is extremely broad, she feels it's essential that the CVB,
'has sufficient resources to develop its functions and to operate smoothly across both sectors'
and it's important that its role,
'is clearly set out and communicated to the public.'
Gelligaer Community Council stated that,
'The new body should be adequately resourced so that it can maintain a presence in local communities and so that the complaints advocates can hear from people who cannot leave their place of care.'
And that's a really important one.
The Royal College of Physicians said:
'this new body should receive the education, training and investment it needs to ensure it effectively delivers advice and support to patients, their friends and family, and the general public about the care they receive.'
We all say we want to support this new citizen voice body so that it can truly represent the voice of the citizens of Wales. In order to do that, in order to undertake that training, that public engagement, that education, an indemnity for volunteers, it needs to have sufficient financial resources. These amendments, 57 and 58, are there to ensure Welsh Ministers make those sufficient resources available.

Rhun ap Iorwerth AC: As I've already noted, we have our concerns about the nature of the citizen voice body that the Government is proposing to set up. But if it is going to be set up, then we have to ensure that it has the ability to operate in a way that has force and power behind it. And, of course, having the appropriate level of resources is vital in that.
Once again, I think that I expect the Government to argue that there's no need for what the amendments call for, because the Minister doesn't have any intention to not provide the resources needed by the new body. But, of course, this legislation doesn't only relate to today's Government, but this legislation is going to commit Governments in the future, and we need assurances for the future. We don't have any assurance about what the health Ministers of the future will do, and, of course, the Minister will be very aware that bodies that are critical of the Government are ones that always carry the risk in terms of losing their funding. So, we need the assurance that's provided by these amendments.

The Minister to contribute to the debate—Vaughan Gething.

Vaughan Gething AC: Thank you, Llywydd. Unfortunately, I don't support the amendment in the name of Angela Burns. I've been clear on the importance that I attach to establishing a citizen voice body that represents the interests of people across both health and social services. One of the fundamental aims of the Bill is to establish a new national body to represent the citizen voice, with a renewed profile and status, and that is a principle that we are entirely committed to. And in order to achieve it, we will of course need to provide resources that are at a sufficient level. The wording in the Bill that
'Ministers may make payments to the Citizen Voice Body',
is the same formulation that has been used when other Welsh Government sponsored bodies have been established, and I gave examples in Stage 2. And as I drew on in the Stage 2 proceedings, we've set out in the regulatory impact assessment the additional investment to be made in the new body at the starting point. These show that the per capita money we're proposing to spend on the body is almost three times the amount that the UK Secretary of State spends on Healthwatch in England. In addition, it's worth noting, and I reported in Stage 2 committee, that we already spend more on our current CHC movement than equivalent bodies in England, Scotland and Northern Ireland. On a per capita basis, the new body will have an increase to go up to £1.32 per head for the population. That compares with equivalent bodies in England that spend 54p per head, 48p per head in Scotland and 84p per head in Northern Ireland. This is comparatively a well-funded body compared to its counterparts right across the United Kingdom.
Welsh Ministers are wholly committed to making payments to the citizen voice body to enable it to perform its functions. Consequently, there is more than sufficient evidence, I believe, to demonstrate that we will be providing the body with the funding it requires to exercise its functions. The body will be a Welsh Government sponsored body. Welsh Ministers provide that body with funds that are sufficient for it to do its job and deliver its functions. Determining what sufficient funds are will be based on a dialogue between the body and Welsh Ministers, as we do with every Government sponsored body. They will of course be in a position to make their case to Welsh Ministers if it is of the view it requires additional funding to undertake their functions properly. Now, I believe that we've set out a case that places this inexactly the same way that other Government sponsored bodies are, in the way that undertake their functions, and I ask Members, therefore, not to support the amendment in this group.

Angela Burns to reply to the debate.

Angela Burns AC: Oh dear, oh dear, Llywydd, I think I rest my case. Rhun ap Iorwerth made a very good point about the fact that these kinds of bodies are the ones that often are the first to lose their funding when times are tight, and, basically, the Minister's reason for not wanting to ensure that—. No, Rhun ap Iorwerth said that. The Minister's main case for not wanting to make sure that there's enough funding in place is the fact that they've already got loads, they've got much more than England, they've got much more than Scotland, much more than Northern Ireland. I don't care. I want a citizen voice body that does the job to protect the Welsh citizen and to be the voice of the Welsh citizen. The funding they have at the moment has to cover the creation of a brand-new body to ensure that it runs well across our very large landscape that we have in Wales. [Interruption.] Yes, of course.

Helen Mary Jones AC: Thank you very much. I'm grateful to you for taking the intervention. Would you also agree with me that, of course, this body is being asked to look at the whole social care as well as health, and that if they're going to be able to do that adequately, then, surely, the amount of resourcing they're going to need is going to be a lot more than what the community health councils use and need at the moment?

Angela Burns AC: Excellent point, Helen Mary, and well made. We need to ensure that this body can do what it's supposed to do. We do not want it to be hamstrung by a lack of funding. We do not want it, in the years to come, to suffer a slow death by a thousand cuts. It's here to represent the citizen. It is their one and only true voice that belongs to them. You need to fund it, Minister, and you need to make sure that that's enshrined in law so that the next person who comes along after you, who may not be quite so generous-hearted, doesn't swipe their funding and use it for something else.

The question is that amendment 57 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 57. Open the vote. Close the vote. In favour 21, no abstentions, 27 against. Therefore, amendment 57 is not agreed.

Amendment 57: For: 21, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 58, Angela Burns.

Amendment 58 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 58 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 58. Open the vote. Close the vote. In favour 20, no abstentions, 27 against. Therefore, amendment 58 is not agreed.

Amendment 58: For: 20, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 12: Citizen Voice Body—audit (Amendment 13)

The next group of amendments relates to audit arrangements for the citizen voice body—group 12. Amendment 13 is the only amendment in the group and I call on the Minister to move his amendment. Vaughan Gething.

Amendment 13 (Vaughan Gething) moved.

Vaughan Gething AC: Thank you, Llywydd. I'm happy to move the only amendment in this group.
Members will be aware that, as introduced, the Bill did not require the Auditor General for Wales to come to an opinion on the regularity of the citizen voice body's accounts. Amendment 13 requires the auditor general to come to that opinion on whether the expenditure to which the accounts relate has been incurred lawfully and in accordance with the authority that governs it. This adds further accountability and vigour.
I think it's worth noting that my officials have held discussions with the auditor general's office regarding this amendment, and they're supportive of it.During these discussions, it was agreed the new proposed process will greatly strengthen the audit requirements for the citizen voice body.I ask Members to accept this amendment.

Angela Burns.

Angela Burns AC: Merely to say that the Welsh Conservatives support this amendment.

Rhun ap Iorwerth AC: We too will be supporting this amendment. We do believe that this will add to the efficiency of the CVB.

Does the Minister wish to respond? No. The question is that amendment 13 be agreed. Does any Member object? No. Amendment 13 is therefore agreed.

Amendment agreed in accordance with Standing Order 12.36.

Amendment 14 is our next amendment. Is it moved by the Minister?

Amendment 14 (Vaughan Gething) moved.

Vaughan Gething AC: Move.

The question is that amendment 14 be agreed to. Does any Member object? [Objection.] We'll therefore move to a vote on amendment 14. Open the vote. Close the vote. In favour 37, no abstentions, 11 against. Therefore, that amendment is agreed.

Amendment 14: For: 37, Against: 11, Abstain: 0
Amendment has been agreedClick to see vote results

Group 13: Citizen Voice Body—structures and engagement (Amendments 40, 19, 59, 75, 20)

Group 13 is our next group of amendments, and it relates to structures of and engagement by the CVB. Amendment 40 is the lead amendment and I call on Angela Burns to move the lead amendment and speak to the other amendments in the group. Angela Burns.

Amendment 40 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Diolch, Llywydd. I'd like to formally move amendments 40, 19 and 20.
This comes to the nub, to the heart, of the citizen voice body. If you talk to the citizen, they want a voice body, they want a representative body that's local to them, understands their local issues, understands their local health board, somebody they can access easily—and, of course, it's not just health boards now, it'll be the local residential home, private or public, it'll be domiciliary care, it'll be across all sorts of settings. There is a fear by significant parts of Wales that we get chopped out of the equation, and that everything is centred here in the south-east. North Wales, in particular, has a very strong sense of that disconnect; west Wales has a very strong sense of that disconnect, and we don't want that to happen. So, this is why we've tabled these amendments, to try to ensure on the face of the Bill that it's not just a promise, but it's actually in writing, that this voice body will represent people on an as-near-to-them-as-possible basis.
Now, I am not, as you all know, an entirely unreasonable person, and I have discussed this matter with the Minister at great length and listened to him in various stages, talking about this. So, I have moderated from saying that I want an absolute replica of the CHCs—one for Pembrokeshire, one for Carmarthenshire, one for Ceredigion—and I'm prepared to go down the regional model, which is why amendment 40, which deals with that structure of regional body is very, very important. It is similar to amendment 59, tabled by the Minister, and amendment 75, tabled by Rhun ap Iorwerth. But we think, having talked to the Minister, and having talked to various people, that if we could build it on a regional basis, perhaps reflecting our regional partnership boards—which are there, which are enshrined, and we've been told that so much of our direction of travel over the next five or 10 years is going to hang on those regional partnership boards—it seemed very obvious to make them the footprint for a regional voice body.
I'm very sad that, despite our conversations, the Minister has remained intransigent about this point. He wants flexibility, and I understand that desire. But I would warn you, Minister, that your quest for flexibility here, as has been the case throughout the Bill, runs a very real risk of leaving too much off the books—too much down to subsequent decisions, subsequent guidelines, subsequent promises and subsequent intent. And above all, what we don't want to see is some body that is centralised in a place where, if the citizen wants to access them, they have to phone into this place, and maybe somebody will come out—maybe somebody will come from Cardiff to Pembrokeshire, maybe somebody will come from Cardiff to Arfon to listen to somebody, hear their problems and try and sort them out. That's not what we want. So, we are very keen to see our amendment, which enshrines the locality, actually put onto the face of the Bill. And if our amendment were to fall, then I would support the Plaid one. Although, my only comment is that the structures that you are suggesting it could be based on could be changed in the new format, if they change local government, if there's, you know—. So, that's why we went for the regional partnership boards, because we think that, whatever happens, they'll probably be the rocks that never, ever move.
And, Minister, I thought about this long and hard, because I thought, 'Well, if our amendment falls and then Plaid Cymru's falls, the next best thing perhaps would be to adopt your amendment, which promises face-to-face consultation wherever possible, however possible', but the more I thought about it, the more I thought, 'No, that's just not right.' This is a body to represent the citizen's voice, wherever they are, not wherever you or the body are—big difference.

Rhun ap Iorwerth AC: There are five amendments in this group. We will be supporting the three that have just been described by the Conservatives.
Amendment 59 is a Government amendment that is a step forward from what we had previously—it talks of the need for the citizen voice body to represent everyone in all parts of Wales. But, do you know what? Those are words, and what we've tried to do through drawing up our amendments for Stage 3 here was to try to put some meat on the bones in order to persuade people that we are serious about creating a new body that will feel close to them, because that is important. Because it's not just the voice of patients—that's not what the CHCs have been; they're also a voice for the communities in which those patients live. And that direct relationship, I think, between the patient voice or the community voice and the communities that they advocate for is something that is truly important to me. And the fear of losing that is one of the main reasons why we cannotwhy we cannot support this Bill as it currently stands. Because it takes a strong local body with a strong local presence and it will scrap that and put in its place a body that has a structure that we don’t quite yet know what it’ll look like, and a presence at a local level or a regional level, but we have no idea how it will ultimately look.
And let me tell you how this Bill looks from the perspective of north Wales, for example. From the north Wales perspective, it appears here that we have a Bill that is seeking to scrap a very effective community health council in north Wales because it has been very effective in its scrutiny of the Government’s record in running Betsi Cadwaladr. That’s the perception in north Wales. There’s no doubt about that. I’ve referred once already to the excellent work that the north Wales community health council has been doing over the past few weeks and months in engaging with the public across the north-west of Wales on the changes—the disastrous changes, as I see them—to vascular services. And I’ve congratulated them on their work in that area.
Does anyone really believe that a national citizen voice body that is centralised in terms of its ethos could provide that same kind of local scrutiny? I don’t feel that that scrutiny would be in place. Some people would say that it would be focused on south Wales. Now, I don’t want to see a split between north and south. I want an united nation. But I will say that, if you get your way as a Government, establish the CVB and put its HQ in north Wales. That would be positive and would perhaps be a solution to the picture I painted as a scenario just a few moments ago. But that doesn’t resolve problems in other parts of Wales, who would see it as a voice that is overly focused on north Wales. But I have given that invitation now.
But what our amendment and the Conservatives' amendments do is to try and alleviate this problem, to respond to that perception of what is actually happening here by removing that local voice, and what we have done is try to define—. Of course, we’ve been in negotiations with the Government to try and persuade them to provide a definition that can work regionally. We’ve failed, so we’ve brought this forward. And I know that the Government will reject our amendments, and I’m sure they’ll argue that it’ll be very difficult legally to define what is meant by 'regional'. But there are many bodies that work at regional levels, and, to respond to the point made by the Conservatives earlier, we aren’t being prescriptive as to which model to follow here, but we do have many regional bodies—the fire services, the public services boards and so on and so forth—and all the Government would need to do in their policy statement would be to explain what the regional footprint would be.
It could even change over time, and certainly the intention with this amendment is to provide the Government with that flexibility to provide that strong local link whilst continuing from here on in to seek the best model to provide that. We’ve done our very best to meet the Government half way, but we don’t expect the Government to travel with us on that journey, so we will reject the Bill, I fear.

Caroline Jones AC: One of the biggest criticisms of the Welsh Government's plans to replace the CHCs was the loss of the local, regional voice. We have given our support to Angela's amendments because, in our view, they will help restore the local links that would be lost by scrapping the CHCs and replacing them with a small national body with an office in Cardiff, for example. If the new body is to truly be the voice of the citizens it has to have representation in all parts of Wales and be accessible to everybody, regardless of where they live in Wales.

Mark Isherwood AC: Votes on this Bill thus far, I fear, have further weakened the citizen's voice in Wales, further reduced the accountability of public servants, and further tilted power away from people and places to public bodies. But these amendments provide an opportunity to reverse that trend, where only independent local voices give true challenge locally. This is critically important, as we've heard, particularly in Betsi Cadwaladr university health board area, where the community health council has been particularly effective in providing a citizen's voice, sometimes perhaps to the annoyance of people in public bodies and people in Government, but we need to praise them for doing their job, recognising, as Angela said earlier, that owning a problem, actioning a problem, exposing a problem, addressing a problem, creates positive outcomes, creates reputational gain, creates happy employees and creates happy citizens. The opposite culture creates the opposite of all those things.
As the board of community health councils and community health councils in Wales have said, the intention that the citizen voice body has a local presence covering all parts of Wales should be set out clearly in the Bill. They say the Bill should clearly reflect the intention that the citizen voice body has a local presence covering all parts of Wales. They say a requirement that the body must demonstrate its accessibility to people in all parts of Wales on a face-to-face basis would help ensure that everyone, including those who may not readily be able to travel or access online services, can confidently share their views and experiences with the citizen voice body. The body must be properly equipped and funded to support and develop its staff and volunteer members through appropriate learning and development, they state. They say people across Wales are clear that a new citizen voice body needs to have teeth if it's to be truly strong, truly independent, a true voice to reflect their views and represent their interests in health and social care at national and local level. Because people will only be confident that the new body has these teeth and is capable of meeting their needs long into the future if this is clearly set out within the statutory framework established for the body.
Please prove me wrong: please show that my initial comments are entirely invalid and that you are listening to what makes things work properly, and that you believe we have to have an effective balance of power between Government and the people so that the people's voice is always respected, always heard and always acted upon. Because, at the moment, it looks as though things are going badly in the wrong direction.

Llyr Gruffydd AC: I just wanted to endorse briefly some of the comments Rhun made. Rhun referred to the excellent work that the north Wales community health council has done, particularly on vascular services, but that’s one of very many cases. I can tell you that the CHC has played a crucial role in the work around the newborn intensive care units. You remember that campaign that was ultimately won and the CHC was at the heart of it.
They have been a superb advocate for families and those affected by events at Tawel Fan. That, again, was a very prominent case across north Wales, and the CHC were at the very heart of the work there. We’ve heard about vascular services. There’s the whole agenda around special measures. Once again, it’s the community health council that is the voice of the people. They have been there in all circumstances, fighting and standing shoulder to shoulder with patients and citizens, doing exactly what it says on the tin.
Nobody here should be under any misapprehension: this is seen as the Welsh Government closing down a strong and effective voice and advocate for the people of north Wales. I know that the Minister will argue differently, and he has every right to do so, but that’s the perception.
Now, I don’t know whether some of the CHCs are less effective and that we see the loss of the north Wales CHC because of the failings of others. I don’t know. I’m only aware of the situation in north Wales. I tell you now: the perception is that it’s seen as a way of avoiding the scrutiny and the accountability that the health board and the Government have faced over a period of years.
You could do one thing to send a clear message to the people of north Wales. You could make a decision that this body will be located, as Rhun said, in north Wales. I think that would go some of the way to alleviating some of the concerns of people in north Wales. But, unfortunately, losing the community health council will be a loss and the Government has a great deal of work to do to convince people that there isn’t another agenda being played out here.

I call on the Minister, Vaughan Gething.

Vaughan Gething AC: Thank you, Llywydd. I have listened again to the debate on these amendments, as, indeed, this has been a significant part of the passage of both the White Paper and, indeed, through Stages 1 and 2. Now, I do, though, recognise that we're broadly at the same starting point, which is how we ensure that the citizen voice body represents the interests of people throughout Wales and is accessible to people in all parts of Wales.
I indicated during Stage 2 scrutiny that I would meet with opposition health spokespeople to listen to their concerns and try to find a common way forward. The meeting was constructive and we did make progress in agreeing how the Bill might be improved. It's unfortunate that we weren't all able to come to agreement on a common position, but it is a positive step that there has been some recognition that the Government amendment represents a step forward. I am, though, pleased to indicate that the Government will support amendments 19 and 20. I agree that, if passed, those amendments will strengthen the Bill. I've always been clear throughout the scrutiny process that the new body, to deliver its interventions effectively, cannot be remote from the people whose voices it needs to represent. Requiring the body to have regard to the importance of face-to-face engagement when they're seeking views and providing complaints assistance, as required by amendments 19 and 20, I believe takes a further significant step forward in that regard.
Amendments 19 and 20 complement the Government amendment 59, which adds further strength in this area, and I am, of course, happy to support them. The Government amendment 59 requires the body to set out in its statement of policy how it proposes to ensure that it can represent the interests of people in all parts of Wales, is accessible to people throughout Wales, and also how it proposes to ensure that its staff and others who act on its behalf, such as volunteers, are able to engage effectively with people throughout Wales. That places clear duties on the citizen voice body relating to its engagement with people throughout Wales. This isn't just a Bill for north, south, east, west or mid Wales; it's a Bill for the whole country, a citizen voice body for the whole country. And it will have to publish a statement explaining its policy in this respect. So, I would ask that Members support Government amendment 59 and the two amendments that I've previously mentioned, 19 and 20.
However, I don't support amendments 40 and 75. I'll deal with amendment 75 first, because I don't believe that it achieves what the mover actually wants it to. When you look at the wording of it, it really isn't clear what a regional level is, and I think it's important to be clear about what's proposed. Similarly, it is not clear in amendment 75 what an 'effective permanent presence' means. It could mean an operational full-time presence, or it could mean something that exists in perpetuity. Now, I remain of the view that not only are there technical challenges there, but also, on amendment 40, requiring the citizen voice body to establish regional bodies along regional partnership board footprints at least has some certainty in our current arrangements.
However, I still believe, and I come back to this point about independence, that, for an independent body—and the new citizen voice body will be significantly more independent than the current arrangements for a hosted body within Powys health board—they, the citizen voice body, should not have their ability restricted in determining what their local structure should be. The body itself will be best placed to judge this, based on what I'm sure will be the changing local needs over coming years, and it will have the knowledge to know how to operate most effectively. Placing constraints is not, I believe, in the best interests of the body nor the public whom it will ultimately serve. I'll take the intervention and then I'll finish.

Rhun ap Iorwerth AC: Thank you for taking the intervention. You've referred a couple of times now to Powys. Speak directly to my constituents and people in the north of Wales—and I explained how I believe this is perceived by them—how do you explain to them that the citizen voice body that you are proposing will be more independent, will be holding you firmer to account, than the community health council and the excellent work that it has been doing in the north of Wales over the past few years?

Vaughan Gething AC: An arm's-length corporate body, able to enter into its own contracts, its own arrangements, its own leases, is significantly more independent than a body that is hosted by Powys Teaching Health Board. All of the community health councils' staff at present are employees of the national health service through Powys health board. Now, to move those people to an independent, arm's-length corporate body, able to determine their own affairs, is undeniably a more independent way of operating than their current arrangements. Those are the facts of what is being proposed. The challenge here is whether Members are able and willing to describe honestly the difference between that set of arrangements and the ones that currently exist.
The current Bill gives the citizen voice body the power to establish committees, to enable it to establish local or regional committees that are focused on local or regional needs as they, not the Government, see them. It can, as I've mentioned, enter into contracts or leases for premises. Therefore, it can determine where its offices should be based. It won't simply be tied to a location determined by Ministers in Cardiff, as is often supposed to be the case. It will be up to the citizen voice body to determine where it is based, not just its head office, but all of its other regional locations as well.
The desire not to prescribe the structure is not linked to money. The regulatory impact assessment clearly includes costs for multiple offices. The costs in the impact assessment are based on the current CHC accommodation, which has staff spread across 12 locations within Wales. In developing and preparing its statement of policy, I'd expect the body to engage and involve stakeholders to ensure that its arrangements are actively supported by people across Wales. I believe that strikes the right balance between allowing the body to determine its own local structure, based on its own assessment, whilst placing a requirement on the body to ensure that it is accessible to and able to represent all people across Wales. So, I remain committed to an organisation that has local roots, but where the body itself determines where it is based and how it is organised, and I ask Members to support that approach.

Angela Burns to reply to the debate.

Angela Burns AC: Thank you very much, Presiding Officer. Let me just deal with this by picking out little bits of it. I want to put to bed the 'hosted by Powys' argument, because I think, actually, that's disingenuous; smoke and mirrors, if you like. Powys doesn't have any hospitals—[Interruption.] I haven't finished my sentence, Kirsty Williams, I know that you like to defend Powys at all accounts, I was just going to finish my sentence—of huge note. Thank you. They've operated very well under the Powys umbrella. I actually don't think that, 'They're going to be more independent and, therefore, they'll be better', cuts any mustard, because they've already shown that they can be better, that they can be independent. Llyr Huws Gruffydd made an absolutely stunning case for the north Wales CHC and the outstanding work that they have done over the last few years, especially calling to—

Vaughan Gething AC: If I can give a specific example—thank you for taking the intervention—on the challenges that the current arrangements provide: when, with the previous chief executive of the community health councils movement, there was a challenge about his conduct, community health councils themselves couldn't take action because he was an employee of the national health service. Powys had to agree a range of actions to take. That's my point: they couldn't undertake a range of measures. They can't enter into their own leases, they can't do their own employment issues, in their current form. This new way of operating that we propose will allow them to do so and give them the distance and the power to control their own destiny.

Angela Burns AC: I did not say, at any point during my contributions, that they should not be independent of Powys. I do not think it is a primary reason for making these changes to the citizen voice body. My personal view is that a lot of the changes to the citizen voice body could be construed—in fact, I do construe it—as a bit of a muzzling exercise: let's get them on board. I want to make sure that that citizen voice body—. It's not my voice body, it's the voice body for my constituents, your constituents, and your constituents, and I want to make sure that they believe that it is their citizen voice body.
I don't think they care at the moment where it is hosted and by whom, but I do take your point that it should be an independent body, and I'm very happy for that to happen. What I'm not happy about is: nowhere in this Bill does it say, 'When you reconstitute yourself, and you regather all your directors, and you regather your staff and your chief executive and your chair, you will, you must, ensure that you have arms and legs, you have soldiers on the streets of Wales in each and every corner and part of Wales.' It doesn't say that.
And I'm very disappointed in your amendment 59. While I'm thrilled that you've accepted 19 and 20, which you and your officials worked on with me, I am disappointed in 59 because our amendment 40 was based on your commentary in the meeting that we had that regional health boards might be the solid rock on which to build it. So, I was prepared to come forward—yes, you did. I came forward and said, 'Okay, I will row away from there being one in Hywel Dda and one in here and one there, I'll build it on a slightly bigger footprint.' Regional boards were seen, partnership boards were seen as the key way of doing it. So, that's why I'm very disappointed in your amendment 59 and why I won't be supporting it.
Because I am desperately worried that, not only are we going to end up with a Bill that doesn't have the appropriate method of being able to say, 'If you fail on your duty of quality, these are what outcomes we expect; if you don't do it, this is what will happen—and for your duty of candour', and there's no real measurement or teeth in the whole thing, but we're now going to end up with a citizen voice body where—and I hear you say that it won't happen—in theory, the new team could say, 'We're going to have just one body and what we'll do is we'll just have representatives over there who'll all be volunteers and they won't be staff.'
Let me tell north Wales that, as somebody who lives in west Wales, I am perfectly happy for the citizen voice body to be based in north Wales, because what I want it to do is I want it to be based in a place where you feel on the edge of things, where you feel marginalised, where you kind of feel actually left out. So, I'm perfectly happy for it to be based there, because I know that, if it is based in a place like north Wales, the people running it will have a really clear understanding of why it is so important that all the corners of Wales, all the edges of Wales, are brought in and represented and given a voice. So, I don't have any problem with that suggestion, and I would like everyone to please support amendments 40, 19 and 20.

The question is that amendment 40 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 40. Open the vote. Close the vote. In favour 21, no abstentions, 27 against. Therefore, the amendment is not agreed.

Amendment 40: For: 21, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 19 is the next amendment. Angela Burns.

Amendment 19 (Angela Burns) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 19 be agreed to. Does any Member object? No. Therefore, amendment 19 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

Amendment 59 is the next amendment. Minister.

Amendment 59 (Vaughan Gething) moved.

Vaughan Gething AC: Formally.

If amendment 59 is agreed, amendment 75 falls. The question is that amendment 59 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 59. Open the vote. Close the vote. In favour 28, three abstentions, 17 against. Therefore, amendment 59 is agreed. Amendment 75, therefore, falls.

Amendment 59: For: 28, Against: 17, Abstain: 3
Amendment has been agreedClick to see vote results

Amendment 75 fell.

Group 14: Citizen Voice Body—representations to public bodies (Amendments 41, 76, 1, 42, 77)

This brings us to group 14, which relates to representations to public bodies by the citizen voice body. The lead amendment in this group is amendment 41, I call on Angela Burns to move the amendment and speak to the other amendments in the group. Angela Burns.

Amendment 41 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Thank you, Llywydd. I'd like to formally move amendments 41 and 42, tabled in my name. This issue was first raised, or amendment 42 was first raised, at Stage 2 by Plaid Cymru spokesperson Helen Mary Jones with my full support. It's in line with committee recommendation 13 at Stage 1. During our evidence sessions, it became very apparent that the body should be able to make representations to Welsh Ministers as this would enable the body to become actively involved in and influence the design of future health and care systems in particular.
The board of community health councils noted that if 'A Healthier Wales' was aimed at putting the citizen's voice at the centre of healthcare, to drive development and delivery of health and social care, the new body should have the right of representation at a national level. Specifically, it was stated that it's more than about making written representations and getting written answers. It's about being in the room when the conversation takes place. It's about being around the table. It's about driving that agenda with policy makers and planners.
The Royal College of Nursing felt that it was important that the citizen voice body should be able to influence the provision of health services. And it's very disappointing that the Minister has continually rejected this recommendation wholesale, on the grounds that Welsh Ministers do not commission or provide services. But of course, Minister, what you do do is you set the direction of travel. That's what the parliamentary review was about. That's what 'A Healthier Wales' is about, and all the iterations that will follow it over the years. We make a lot, don't we, about listening to the voice of the citizen, about staff engagement, about all these soft, fuzzy things, but we actually have to start delivering it, and we have to start engaging with people.
I tabled amendment 42 after further consultation with the board of community health councils at Stage 2, because the amendment as drafted imposes both a duty to respond to the representations, as well as a duty to comply with guidance issued by the Welsh Ministers relating to the representations made.
We would reject amendment 1, again on the basis that this is too weak to be able to respond to the strength of concerns that we received during Stage 1. Guidance alone is not enough in these circumstances. At Stage 2, the Minister was keen to reject the right on the basis that these representations would have to be made public, and that a response to a representation may not be something that should be provided in writing. I would contend that this amendment also clearly states that guidance would be issued about how listed persons would respond. We can also see where guidance fits in, but we're adamant the duty to respond must remain on the face of the Bill.
Amendment 41 amends section 15 on the citizen voice body representation to public bodies, extending it to Welsh Ministers and any other person who makes decisions on behalf of a local authority or NHS body, and we think that this provides a broader approach to representations made.
We do oppose amendment 76, on the basis that amendment 41 widens the list of bodies that the citizen voice body can make representations to. Again, it's the same argument I made at Stage 2; in fact, a similar amendment that was limited to Welsh Ministers was withdrawn at Stage 2 in favour of this amendment.

Rhun ap Iorwerth AC: Our amendments here specify that not only should Welsh Ministers be able to be recipients of representation by the CVB, as is proposed by the Conservatives, but that if they do receive representation the Government then has to provide a response. So, I would ask the Conservatives to perhaps look at ours as an improvement on their amendment—or at the very least, if your amendments fall, that you consider supporting ours as having another crack at it. I do appeal for support from across the Senedd.
I'm starting to think that we're talking about a dental Bill here, because I'm going to talk about teeth again. [Laughter.] This is another one of those elements where we're calling for this Bill to have real teeth; rather than talk about raising standards in ambiguous terms, that there are actual steps that are supported through legislation to make sure that improvements happen and, when concerns are raised, that they are acted upon. That is precisely what our amendments here are designed to do.
This is vitally important, I think, to ensure the CVB does have teeth and is able to hold the Minister to account. I know he doesn't like to be reminded of the fact too often, but he is actually responsible for running the health service in Wales, and I think it's pretty relevant, therefore, to provide the CVB with the power to make representations to him and to his successors. And, of course, it's also important that any body in receipt of a submission provides a written response, otherwise the CVB will just be on a list of organisations that perhaps feel that they are being ignored. So, we think that this is extremely important. A failure to back these amendments today would simply add further evidence to our view that this legislation is really about removing an effective scrutiny body, replacing it with a toothless body, and, again, another reason why we can't support the Bill.

Caroline Jones AC: Diolch, Llywydd. To be an effective champion, the citizen voice body must be heard. The community health councils have been an effective champion for Welsh patients, in part, because of their right to be heard. Public bodies have to take notice of representations made by CHCs. The amendments tabled by Angela and Rhun extend this duty to the citizen voice body. If this new body is to be our voice, public bodies should have to listen to what they have to say. We no longer live in an era when healthcare was dictated to us; patients have a right to be involved in their own health and care. It is therefore essential that the citizen's voice be heard when it comes to planning and delivering services and changes to those services. Without amendments 41 and 42, the new body is a citizens' body, but without a voice.

The Minister, Vaughan Gething.

Vaughan Gething AC: Thank you, Llywydd. All of the amendments in this group relate to representations being made by the citizen voice body and the response that should be provided to them, but they, of course, have different permutations. And I do want to make clear again that, despite the language being used, refusing to agree to amendments 42 or 77 are not examples or evidence of bad faith, or a deliberate desire on thepart of the Government to emasculate the current CHC movement and replace them with a toothless body. There is room for honest disagreement, as I recognise both within my own party, and across this Chamber as well. And we have drafted the Bill to enable the citizen voice body to make representations to NHS bodies and local authorities, as organisations that provide or commission the vast majority of health and social care in Wales. As such, they are best placed to take an overview of services in their area, and be most effective in compelling changes on the ground, and responding to the matters related to their representations.
Both of the amendments in this group seek to add Welsh Ministers to the list of bodies to whom the citizen voice body may make representations. I've been clear that there is nothing to prevent the citizen voice body from corresponding with Welsh Ministers, and, as with any key stakeholders, we don't just take that body's views into account in exercising our relevant functions, including policy and legislation, but we already ensure that we do respond to people who write to Welsh Ministers. Any and every Welsh Government-sponsored body that writes to Ministers receives a response, and that would be exactly the same in terms of the normal ongoing dialogue with Welsh Ministers and the new citizen voice body.
Amendment 41 also refers to representations to be made to any other person or body who makes decisions or exercises functions on behalf of a local authority or an NHS body. And that was not, of course, a Health, Social Care and Sport Committee recommendation. It is, though, incredibly broad. It could be particularly onerous for smaller providers of social services, especially in view of the requirement in amendment 42 for providers to publish their response on their website—not all providers actually have websites. But I do have real concern about the requirement to publish all responses.
The body's ability to make representations is deliberately very broad. This does mean, however, that it may not be appropriate in some instances to publish responses. The person or people who the citizen voice body are making representations on their behalf may not want to have representations published. However, the amendment that Members are asked to vote for gives absolutely no flexibility in respect of amendments 42 and 77, and the drafting of the amendments really does matter. It doesn't say that they 'may' publish, or 'should consider' publishing; the amendments make very clear, in either version, that they 'must' publish their response on their website. And you can't amend that clear and unambiguous statutory requirement in guidance.
Placing these duties on service providers runs contrary to the approach taken under the Regulation and Inspection of Social Care (Wales) Act 2016 that this place has already passed—to place proportionate duties on service providers, empowering them to find the best ways of meeting regulatory requirements. It is appropriate that representations are made to the bodies that have statutory responsibility to the public for providing health and social care—local authorities and our NHS. And that is what the Bill provides for. I don't agree that there is a need for further provision on this—the citizen voice body will have ample opportunity to shape national policy and highlight best practice, as the body is being designed to do.
In terms of the requirement for a response to representations that sets out the extent to which the recipient accepts the representation, and any actions that the recipient intends to take, that is formulaic and potentially, encourages an adversarial rather than a co-operative approach. And it doesn't take account of the fact that it may be more appropriate—within the context of the particular circumstances of the kind of representation being made—to deal with matters as part of an outcome-focused discussion, rather than formal written correspondence, through a prescribed process, as amendments 42 and 77 would require.
The Government amendment in this group seeks to resolve what we understand is the chief concern and desire: for NHS bodies and local authorities to have a clear system for dealing with representations received from the citizen voice body that is proportionate to the issues raised in the representation; for the citizen voice body to be kept appraised of progress in dealing with their representation; and, crucially, to make sure that they are advised of the outcome to their representation. The Government amendment will ensure—through statutory guidance—that NHS bodies and local authorities have that proportionate and operational procedure in place for considering and responding to representations. And I believe that that will be conducive to ongoing working relationships between the parties, and will mean that the body is advised of the eventual outcome of making any representation. And I ask Members to support the Government amendment in this group.

Angela Burns to reply.

Angela Burns AC: Thank you very much indeed. There is a bit of an issue here, really, isn't there? I didn't just sort of sit down and knock out these amendments in the dark one night; I actually had a lawyer team who worked on it. So when you stand there and say, as you have done a couple of times throughout this, 'This isn't written very well, this isn't in the right terminology, this says this, that or the other', I want to make it very clear that I also—it's not just your lawyers in the room, there are our lawyers in the room. And they are very clear that these amendments actually allow that element of discretion. They're very clear that the guidance could be issued about how listed persons would respond. So you don't have to actually put out in the public sphere exactly what is said.

Vaughan Gething AC: Can I just refer to amendment 42(6)?
'As soon as reasonably practicable, the recipient of the representation must publish the response prepared under subsection (4) on their website'.
That leaves no room for any discretion whatsoever; the word 'must' in this drafting is very clear and unambiguous.

Angela Burns AC: Yes, but you don't have to put their name, their address, their rank and serial number. So I think you are being a tad disingenuous here. And that's what the guidance can lay out. And this is taking legal advice; all opposition parties work with teams of lawyers—it isn't just the Government that has these guys who know what they're talking about. So that's my first observation on this.
My second observation on this is that it's more than just about writing in and getting you to write back. This is about the citizen voice body actually being able to engage with Welsh Ministers, and start to help formulate the direction of travel for the delivery of health services in Wales, how it reflects in their local areas. And that's why we've tabled these amendments, and that's why we're asking Members to support them.

If amendment 41 is agreed, amendment 76 falls. The question is that amendment 41 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 41. Open the vote. Close the vote. In favour 15, no abstentions, 33 against. Therefore, amendment 41 is not agreed.

Amendment 41: For: 15, Against: 33, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 76 is next. Rhun ap Iorwerth.

Amendment 76 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 76 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 76 in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, no abstentions, 27 against. Therefore, amendment 76 is not agreed.

Amendment 76: For: 21, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 1 is the next amendment. Minister.

Amendment 1 (Vaughan Gething) moved.

Vaughan Gething AC: Move.

The question is that amendment 1 be agreed to. Does any Member object? [Objection.] We therefore move to a vote on amendment 1 in the name of Vaughan Gething. Open the vote. Close the vote. In favour 37, no abstentions, 11 against. Therefore, amendment 1 is agreed.

Amendment 1: For: 37, Against: 11, Abstain: 0
Amendment has been agreedClick to see vote results

Amendment 42 is the next amendment. Is it being moved by Angela Burns?

Amendment 42 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

If amendment 42 is agreed, amendment 77 falls. The question is that amendment 42 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 42. Open the vote. Close the vote. In favour 15, no abstentions, 33 against. Therefore, amendment 42 is not agreed.

Amendment 42: For: 15, Against: 33, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 77, Rhun ap Iorwerth.

Amendment 77 (Rhun ap Iorwerth) moved.

Rhun ap Iorwerth AC: Formally.

The question is that amendment 77 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 77, in the name of Rhun ap Iorwerth. Open the vote. Close the vote. In favour 21, no abstentions, 27 against. Therefore, the amendment is not agreed.

Amendment 77: For: 21, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 20 is next—Angela Burns.

Amendment 20 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 20 be agreed to. Does any Member object? Amendment 20 is agreed, therefore.

Amendment agreed in accordance with Standing Order 12.36.

Group 15: Joint complaints (Amendments 43, 47)

Group 15 is the next group of amendments, and they relate to joint complaints. Amendment 43 is the lead amendment in the group and I call on Angela Burns to move the amendment.

Amendment 43 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Thank you, Llywydd. I'd like to formally move the amendments 43 and 47, tabled in my name. Amendment 43, Minister, is a probing amendment and it relates to requiring NHS bodies and local authorities to work together where a complaint is raised, which relates to both of them, and amendment 47 is consequential to amendment 43.
Now, these amendments are based on evidence submitted by the Public Services Ombudsman for Wales to the committee during Stage 1 and further discussions that we've had at Stages 2 and 3. In written evidence, the ombudsman noted his disappointment that the Welsh Government did not proceed with its proposals on joint investigations and the alignment of NHS social services complaints procedures within its White Paper. And I know that this has raised concern with a number of Members, because more often, now, people are having support from the NHS and from social services. And if there is an issue, sometimes it's extremely difficult to say whether the issue is on the health bit or the social services bit, or it might be an issue that actually connects with both. Then to ask the citizen to start two separate complaints processes or raising their concerns via two separate processes for the same issue is actually a big ask, and this is all about making the life of the citizen more direct, easier to manage and less confrontational. That's why I've tabled these amendments, because what we want to see is a joint system only on the instances where the complaints that are being raised are about something that affects both NHS and social services.
Now, I did listen very carefully to the Minister, and that's why this is a probing amendment, because you have said that you want to have a unified complaints process. And I've also heard you say that it will take time to put in place, but it's actually very complicated in that the way an NHS complaint is processed is very different to the way a social services complaint is processed and that, very often, the NHS complaint, because it tends to be much more clinical, will often take much longer because there are far more people who have to be brought in to play and you've got to listen to the consultants and everybody who is involved in it. Whereas, quite often, a social services case might be much more direct and easier to deal with, and marrying the two different types of complaints processes can be very hard. So, I understand that and I agree with you.But what I'm concerned about is how long it might take.
We already heard in the previous amendment that we're seven years on and things that were vital that had been promised still haven't happened. When we discussed this, we did talk aboutan anticipatory amendment,and the point of an anticipatory amendment is to have, within this Bill, the ability for the Welsh Minister to say, 'At a point in the future, guess what, health and social care, I've given you all this time to get your act together, to put your complaints processes together, to help the citizen'—and this is all about helping the citizen—'you still haven't done it, so now I'm going to enact this bit of the Bill that will make you get on and do it.' This is what amendments 43 and 47 are about.
I am concerned that there's been a row-back on our discussions over an anticipatory amendment. I do accept you haven't given up on the ambition to have a more unified complaints process. I do welcome your promise that officials will look to arrange a round-table discussion before the summer recess, with the relevant departments. I do think this is still in danger of being kicked into the long grass again, without a statutory commitment.
This is why I've put these amendments forward. I'd be interested to hear, Minister, what you have to say. These amendments allow you to draw together all the stakeholders that need to be consulted. They allow you to drive a future joint complaints process forward through a regulatory framework. In consultation with the Public Services Ombudsman for Wales, we believe that agreement can be reached within six months of this section coming into force, and I would urge Members to support these amendments.

Rhun ap Iorwerth AC: I can confirm that I and the group will be supporting these amendments. The reason for that is that I think that there is a means here of encouraging better joint working, particularly where complaints relate to that space where the interaction truly happens between health and social care.

The Minister to reply.

Vaughan Gething AC: I'm sorry to have to disappoint Angela Burns again, but as Members will know, there were identical amendments on joint complaints tabled at Stage 2, as Angela Burns has indicated. I still don't believe the Bill would be a suitable vehicle to bring these changes forward. Responses to the White Paper consultation and subsequent consideration have indicated further engagement in the area is needed with a range of stakeholders to help develop the policy in the area.
In terms of what the proposed amendment does, my concern is that it is potentially too restrictive. For instance, it requires NHS bodies and local authorities to conduct a joint investigation into concerns raised under the NHS complaints procedure and under the social services complaints procedure regulations. That does not cover the large number of social services complaints made by children under the Representations Procedures (Wales) Regulations 2014, nor does it take account of complaints that are made directly to providers of regulated social care services, such as care homes and domiciliary care providers. This route is particularly relevant for those whose care and support is not managed or arranged by a local authority.
The committee itself recognised that considering the best approach for joint complaints,
'is not a straightforward piece of work',
and urged the Government to continue to work with stakeholders to find ways to simplify the process. I have, as Angela Burns has mentioned, committed to convening a round-table discussion with that wide range of stakeholders to consider how the process could apply to NHS complaints, local authority complaints as well as complaints brought against providers of regulated social care.
There are a number of key stakeholders that need to be involved in delivering on this ambition and work to be undertaken to ensure we deliver effective joint complaints arrangements. Officials are already working to arrange that round-table discussion before summer recess. But I do think that the six-month time frame that Angela Burns refers to in the amendment would be an overly optimistic time frame to be able to complete all of this in good time, even if we were in normal times, and, of course, we're not, in terms of the particular challenges that we know that we're going to face.
But we're taking this approach in this area of joint complaints to bring together a number of different strands that we know have to be in the same place at the same time. As I outlined during Stage 2, the fact that the body will have the ability to assist someone bringing a complaint about health and social care, demonstrates our commitment to making things easier for people who have complaints that span these two areas.
To reiterate, our approach remains to continue to work with NHS Wales organisations, local government and other bodies to discuss ways of making the process simpler for people who have those complaints across health and social care. I hope that Members do recognise the genuine and clear determination of the Government to achieve that goal as part of a more integrated health and social care system that is genuinely people-centred, and developed in partnership with key stakeholders. We will be reviewing and updating our putting things right regulations and associated guidance to ensure that they properly effect the changes we're making through this Bill to introduce a duty of candour.
I have listened to the points that Angela Burns has raised and whilst I think we agree on the ultimate destination for it, I'm afraid that I can't support the amendment that she moves today.

Angela Burns replying.

Angela Burns AC: You have disappointed me, because we did talk about anticipatory amendments, and because I am worried that it will get kicked into the long grass, or it'll be allowed to drag on and on. I've been an Assembly Member for 10 years and one of the first cases I ever had to deal with was of a young man who had been run over by a car and was paralysed from his neck down, and he had healthcare provided to him 24-hour a day, seven days a week, but he was also fostered out—when I say he was a young man, he was a child, a boy—he was fostered out and therefore had social services intervention. That young boy was tortured by the health team. They used to do jokes on him, like take off his incontinence pad and hold it up against his nose, and laugh. He actually had a tracheotomy, and they'd have to change various tubes over and when he—through frustration—used to shout and scream, they'd take it out and then dance around with a new one before they put it back in again, to teach him a lesson. This is a kid who is completely paralysed from his neck down: I've never forgotten him; it was one of my first cases. I worked on his case for two years; it is seared into my soul.
What's really seared into my soul isn't just what happened to him, but the way all of those services slip-shouldered their way. It wasn't NHS; it wasn't social services. I chased around and I had everybody involved: CSSIW; I had health inspectors; the works, and it was extraordinary the wriggle room that was in that complaint process. It was extraordinary how people managed to avoid being responsible, and I vowed then that whatever else I would try and do, I'd try and bring it all together, so that his foster carers, the health professionals who did care about him, the doctor, the GP, could actually chase after the right people and say, 'Oi. You're culpable, you sort it out. You reprimand those people. You retrain those people. You fire that person, and you make that kid's life better again.'
But it didn't happen, because we had to go everywhere with our complaints process. And it's been a nightmare, and that's why—. I'm not asking for you to rewrite it, and this is what I'm worried about, that on the round-table you're talking about doing it all. I'm not asking you to rewrite the NHS complaints process. I'm not asking you to rewrite the social care complaints process. I'm asking you to develop a brand-new system, where on the occasions where it's a joint issue, where there's joint responsibility, then there is a process where the poor citizen who's been hard done by only has to make one phone call, talk to one person and get the whole thing resolved. That you can do in six months. You've got enough stripes on your shoulder, you're a highly intelligent individual, and you can drive that team when you want to, and I do not think that this amendment is unreasonable, because it is about protecting the citizen, and I ask Members to support amendments 43 and 47.

If amendment 43 is not agreed, amendment 47 will fall. The question is that amendment 43 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 43. Open the vote. Close the vote. In favour 20, no abstentions, 28 against. Therefore, amendment 43 is not agreed.

Amendment 43: For: 20, Against: 28, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 47 fell.

Group 16: Citizen Voice Body—duty to supply information (Amendment 2)

Group 16 is the next group and that relates to the duty to supply information to the citizen voice body. Amendment 2 is the only amendment in the group and I call on the Minister to move the amendment.

Amendment 2 (Vaughan Gething) moved.

Vaughan Gething AC: Thank you, Llywydd. Members will be aware that section 18 of the Bill places a duty on NHS bodies and local authorities to supply the citizen voice body with such information as it reasonably requests for the purpose of carrying out its functions. The purpose of this amendment is to place a duty upon NHS bodies and local authorities to provide the citizen voice body with a written response outlining the reasons why it has refused to supply information requested. The duty would apply to any refusal made by an NHS body or local authority.
I think Members can understand that it would be possible to refuse information requests on a variety of bases, for example, the request may not be reasonable and the response should set out what is unreasonable about it; the request may not be related to the exercise of the citizen voice body’s functions; or it could be potentially unlawful to disclose the information requested. I think it is important that there is a requirement for these reasons to be provided in writing. I brought forward this amendment in response to the now Legislation, Justice and Constitution Committee's representations, made after the Stage 1 process.
This amendment will add strength to section 18 of the Bill by placing this duty upon NHS bodies and local authorities to help ensure transparency, and demonstrate accountability when making those decisions. I hope that Members will support the amendment.

Angela Burns AC: Welsh Conservatives will be supporting this amendment.

Rhun ap Iorwerth AC: As this strengthens the Bill, we will reluctantly support it, but we would like to make the point that, actually, we don't want NHS bodies or local authorities to refuse to supply information in the first place. We would really like to see more than just a requirement for written reasons to be provided for refusing information, but the CVB, I guess, had to have the ability to challenge such reasons.

The Minister to reply. No? Therefore, the question is that amendment 2 be agreed to. Does any Member object? No. Therefore amendment 2 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

Group 17: Citizen Voice Body—Entry to premises (Amendments 3, 45)

Group 17 is the next group, which relates to entry to premises by the citizen voice body. The lead amendment in this group is amendment 3 and I call on the Minister to move the lead amendment. Vaughan Gething.

Amendment 3 (Vaughan Gething) moved.

Vaughan Gething AC: Thank you, Llywydd.Following the Stage 2 debate, I met with opposition health spokespeople to discuss a number of issues, one of which, of course, was the question of access to premises, and we did have a constructive discussion. Officials have spoken to stakeholders who represent providers of health and social care, nurse directors of health boards and trusts, the Welsh Local Government Association and a representative from Care Forum Wales, and all were supportive of the code of practice approach.
I’m sure that we all recognise that people’s feedback gathered in real time by an independent and trusted body will provide an important insight and a valuable resource for service improvement. I have also written to the Health, Social Care and Sport Committee to provide assurance on a number of matters, including the code. As you will have noted, we have re-tabled, with a slight technical amendment, our Stage 2 amendment. It places a duty on Welsh Ministers to prepare and publish a code of practice about access to premises where health services and social services are provided. This amendment responds to recommendation 12 of the Health, Social Care and Sport Committee’s Stage 1 report, which called for a qualified right of access.
We considered, at length, many options on access before deciding the code of practice provided the right approach in relation to the functions of the citizen voice body. I will comment shortly on the Welsh Conservatives' amendment, but before doing so I want to put on record that I genuinely believe that everyone is trying to achieve the right result, even if we ultimately don't agree.
I recognise that this is a key part of the Bill and it's essential that we get it right. Our intention is to create a framework that facilitates access to the citizen voice body for people receiving care. Other amendments we tabled at Stage 3, such as the duty of co-operation that requires NHS bodies and local authorities to make arrangements with the citizen voice body to co-operate, to support them in seeking the views of the public, also facilitates co-operation in relation to access to premises. The key objective is to ensure that the body can exercise its functions in a way that recognises the individual needs and circumstances of people receiving care and support in very different settings. A code of practice allows us to reflect how access might best be achieved for people in a range of scenarios and settings, from hospitals to supported living.
The amendment requires the Welsh Ministers to consult on the code, and it is important that we are guided by people who have experience of receiving care in these different settings. Given the requirement to consult, I don't wish to pre-empt its content, but I want to repeat the assertion that I made during Stage 2 that the starting presumption should be that access will be agreed. However, the code may, for example, recommend the factors the body ought to take into account when seeking access to premises; for example, to maximise the opportunity to talk to residents, family and visitors. It may also make recommendations about the need for those conducting visits to have appropriate training and checks.
The code will be supported by existing provision that gives considerable weight to it. For example, on the social services side, part 2 code of practice, issued under the Social Services and Well-being (Wales) Act 2014, states that local authorities must:
'Ensure that providers from whom they commission or procure services encourage and enable the involvement of all people in designing the shape of services and how they will operate to deliver personal outcomes, and that providers involve people in evaluation and review.'
There is therefore a duty on local authorities to ensure that commissioned services enable service users to be involved in shaping services. Now, whilst important, accessing premises is only one way in which the body can seek views. The body will also need to engage not only with current service users but also past users, prospective users and their families. So, accessing premises to seek views is one part of the wider picture.
The code will carry the necessary weight to ensure all parties—NHS bodies, local authorities and the citizen voice body—discharge their respective responsibilities. We have not in our assessment and engagement with stakeholders seen or heard evidence that they would not discharge their respective responsibilities appropriately.
Now, research by both Kent University and LSE, published in July 2018, demonstrated that 99.7 per cent of over 1,000 adult care homes in England reported that visiting could take place at any time. No evidence has been presented to me, or to us, to show that the position would be any different here in Wales. I ask Members to support the amendment, which provides a clear and comprehensive approach to ensure clarity for and certainty across health and social care.
I know that the Member will speak to her amendment, but I would like to set out my views. I have considered the amendment put forward. I appreciate the reference to the code of practice and take from that that the Member appreciates the benefits that a code may bring to this part of the Bill. Unfortunately, even though I don't have any doubt about the intent behind the amendment, I can't support it. The effect of the amendment is, unfortunately, unclear. I believe the intention is to give the citizen voice body a power to access, enter and view premises for the purposes of any of its functions. It appears that the intention is for this right of entry to be qualified by a code of practice prepared by Welsh Ministers, although that is not absolutely clear.
There are real problems with what the code provisions require Welsh Ministers to do. It is impossible, for example, to set out an exhaustive list of the circumstances in which the body may enter and view premises. This does not operate to the advantage of the body or, indeed, to users of health and social services. There will always be unforeseen circumstances which may arise, and the amendment could, therefore, potentially be restrictive.
The amendment also requires the code to set out an exhaustive list of the circumstances in which the citizen voice body may enter domestic premises or private rooms in care homes at the request of an individual. Again, that can't be right. It is not for the Welsh Ministers in a code of practice to set out an exhaustive list of the circumstances in which an individual may invite the citizen voice body into their home. Surely that is a matter for the individual themselves to determine.
I therefore ask Members to support the Government amendment and to reject the amendment in the name of Angela Burns.

Angela Burns AC: As the Minister said, my amendment 45 relates to the right of entry or access to premises via the citizen voice body, and, again, it's based on the committee's recommendation 12 at Stage 1. It's also in line with the views of the current board of CHCs, who do not wish entry to premises to be consigned to a code of practice.
We would reject the Minister's amendment 3 on the basis that a duty to have regard to a code of practice does not go anywhere near addressing the strength of feeling by many stakeholders that the citizen voice body should retain the right of access, nor is it as strong as a right that is set out on the face of the Bill. You have to remember that we are suggesting that we disband the CHCs, replace them with a CVB, and the key asks are that it should be local—it should be run by and for local people—and that they should have a right to access, because having that right to access gives them the chance to pick up things that are sometimes missed. It allows them to be a critical friend; it also allows them to go into some situations and really follow through where people have started to raise concerns and then they find that there are multiple concerns. And we can probably all cite CHCs who've done just that and provided a great service to their local communities.

Angela Burns AC: We also need to remember that, for example, Social Care Wales recommended the Welsh Government revisit their decision, explaining that the power of access fills the gaps of provider capture and situational capture, i.e., it's tilted in favour of the provider. And this is what is encountered during inspection powers. The older people's commissioner said that this function could be flexible, responsive, and act as an early warning system where concerns may be identified before an inspection by Healthcare Inspectorate Wales.
Leonard Cheshire highlighted the importance of a power due to its proactive nature and allowing standards to be measured before the duty of candour is triggered. Gelligaer Community Council, who were very helpful in their responses, and they spoke for a lot of community councils, strongly felt the new body should have the right of access to health and social care establishments. And they cited the Aneurin Bevan CHC as having a very good record of responding rapidly to reports, and through their relationship with the health board, through their positive relationship with health board, affecting changes.
And I do find it disappointing, Minister, that you seek to deny such an important role its full weight. You claimed, in you responses to committee, that inspectorate bodies already undertake this function against regulatory standards. But despite all of the evidence, that actually contradicts that assertion. It was also very disappointing at Stage 2 that you believed that both of the opposition amendments were drafted in such a way they could be interpreted as inspection functions because that is most certainly not what we were trying to do.
And I did listen to you when we met to discuss this prior to Stage 3, and I did listen very clearly to your concerns about the human rights considerations, and that's why I've submitted a redrafted amendment to try to encapsulate some of those concerns. And I heard you, at Stage 2, saying that you'd had constructive conversations with the CHCs about this right of entry, but they're adamant that it should be retained on the face of the Bill.
The advice I received in connection with the human rights elements highlights that any provision of a Bill must not contravene the ECHR to fall within legislative competence. In this instance, article 8 on the right to a private life. I've further been informed that the fact that a code of practice will set out qualifications that should ensure that article 8 is not breached is not enough to ensure a provision does not infringe article 8 and therefore be within competence. So, as such, the more qualifications given to the right of access on the face of the Bill, the less likely article 8 will be infringed. My amendment, therefore, I believe, achieves this requirement.
And I'd like to remind you that we are particularly mindful that, in evidence, the board CHCs reassured us that the powers wouldn't extend to health and social care services that were not directly provided from settings that are owned, managed or leased by health and care bodies. Furthermore, the board's legal advice notes that the human rights Act's considerations would not be triggered in these instances as they are seeking a right of access to communal areas, not private rooms. Therefore, the amendment, as drafted, seeks to take into account that the Bill must not contravene the European convention on human rights. So, we've ensured that that article 8 on the right to private life is not breached. So, in other words, if you want to go in and do an inspection on a care home because either it's part of your routine or because you've heard that somebody's got some concerns, you can request to go in, you can go in, you can go to the private areas, but if a resident or two residents at that care home also say to you, 'Please come into my private room, I want to talk about this, I'm raising concerns', then they would go in by invitation. So, it isn't about marching into a private room, a private home; it's about going in with invitation but going into the communal areas. And we believe that this amendment would absolutely encapsulate that and preserve it. And I would be grateful if you'd consider your position on the right of access and support this amendment, because this goes to the heart of the citizen voice body, the fact that they have that right to go out and to look at situations that are developing on behalf of the citizen.

Rhun ap Iorwerth AC: Very briefly, we have felt that it's vital to give the new citizen voice body the power to enter premises where domiciliary care is provided, and although neither, actually, of these amendments reflect the strength that we would like this power to have, we will be supporting both the amendments in the hope that the Minister will continue to provide us with the assurance that we need that the code of practice will allow that to happen.

Caroline Jones AC: In our opinion, amendment 45 is one of the most important amendments we're discussing today. The ability to make unannounced visits into NHS facilities has enabled the CHCs to highlight failings that have impacted patient care. The fact that the Minister's vision for the CHCs' replacement did away with these visits was of huge concern to the majority of opposition politicians, patient advocacy groups and large sections of civic society.
Community health councils have played a vital role in ensuring patient safety, as witnessed recently in my own region with the Cwm Taf maternity scandal. I cannot underline strongly enough the importance of unannounced visits. Members must support amendment 45, otherwise we will be diminishing the citizen's voice in health and social care. Diolch.

Mark Isherwood AC: When the board of community health councils and community health councils in Wales, the patient's voice in Wales, said they supported the passing of this Bill at Stage 2 in the law-making process, they said they were pleased to see the proposals that the Bill should be strengthened in areas, including visits and rights of access. They said the new body's rights of access to health and care settings should be set out clearly in the Bill, by introducing an amendment that said 'The citizens' voice body shall have the right to enter the premises for the purpose of exercising its functions. Such rights will be exercised and enforced in accordance with subsection 2.'
They said that Welsh Ministers must prepare and publish a code of practice about the circumstances in which the body may have access to premises for the seeking of the views of individuals in respect of health or social services, and the circumstances in which the body may enter excluded premises upon the invitation of members of the public for the purpose of seeking the views of those individuals in respect of health or social services, and where access to those premises or excluded premises is permitted or has been agreed, engagement with individuals that those premises are included premises for the purpose. This addresses, for example, the concerns raised by the Welsh Local Government Association in their e-mail to Members today.
Ahead of this Stage 3 debate on the Bill, they, the patient's voice in Wales, said their support for the changes continues to depend on the establishment of a new body that is properly equipped to undertake its new role on behalf of people living in all parts of Wales. They said that the citizen voice body should be able to access health and care settings so it can hear from people about health and care services and that it should do so responsibly. They said the statutory framework governing visits and rights of access for the new body must establish an operating framework that works on the presumption that the body is able to access health and care settings when it considers it needs to, unless there are specific circumstances where it would be unreasonable to do so. They said that this is how the community health councils currently operate and that it works well in the NHS. They said there's no reason why the same approach would not work with the new body. They said local authorities and NHS bodies must make sure, through their commissioning arrangements, that the body can access health and care settings operated by third-party providers such as private care homes, as well as NHS bodies, providing services across the border in England. They said the code should set out clear requirements for this.
If Members really want to give voice to their constituents, if they really want to put the content of society before its form, then they must support Angela Burns's redrafted amendment.

The Minister to reply to the debate.

Vaughan Gething AC: Thank you.I do recognise this is an area where there are differences of view, but we are genuinely trying to accommodate people on all sides in recognising some of the complexities that exist.
And I recognise that Angela Burns has redrafted the amendment she tabled at Stage 2 because of the concerns about access to people's homes, but I still come back to the drafting that is still in here about an exhaustive list of circumstances, and it just isn't possible to draft in that way. It's always dangerous when you start to have a list of what you may or may not do. There will always be circumstances outside the list, even with the finest minds on the planet all in the same place at the same time. I say this from my past life, when being a lawyer—lots of the same lawyers will agree, and lots of the same lawyers will disagree, about exactly the same point and exactly the same wording. So, trying to get to the point where we have an exhaustive list in each those areas I think is not something that we should say is something that we could safely or properly draft and contemplate and provide to people; I think it would give a false level of assurance. The point about the code is we'll develop it together, with the citizen voice body, with others, including people in health and social care, on what the practical circumstances mean.
I'll take the intervention and then I'll finish; I can see the time and I'm keen to finish, and other Members are too.

Hefin David AC: I thank the Minister for taking the intervention. I don't want to prolong proceedings, but this was the issue that I had most concerns about, having had discussions with the Aneurin Bevan Community Health Council. I have to say, following discussions with the Government about the very issues he's just talked about, and with the community health council, I'm happy, following those discussions, particularly with the Aneurin Bevan Community Health Council today, to follow the Government's voting advice on this issue.

Vaughan Gething AC: I think that's very positive, because it does show we're genuinely talking to and listening with people on all sides in the Chamber and outside to try to get this right, and to have a series of real examples about how the code should be applied. And, again, to reiterate my point, the code will start with the presumption that access will be agreed. This is not about unreasonably trying to trammel the ability of the new citizen voice body to undertake its functions, and I would ask Members to support the Government amendment in this group.

The question is that amendment 3 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 3. Open the vote. Close the vote. In favour 37, no abstentions, 11 against. Therefore, amendment 3 is agreed.

Amendment 3: For: 37, Against: 11, Abstain: 0
Amendment has been agreedClick to see vote results

Group 18: Citizen Voice Body—duty to co-operate (Amendments 4, 46)

Group 18 is the next group of amendments and it relates to co-operation between the citizen voice body, local authorities and NHS bodies. Amendment 4 is the lead amendment in the group and I call on the Minister to move that amendment and speak to the group.

Amendment 4 (Vaughan Gething) moved.

Vaughan Gething AC: Thank you, Llywydd. I agree with the board of community health councils in its view that NHS bodies and local authorities could do much to support the new citizen voice body in reaching as many people as possible so that they can share their views and experience of the care and support they receive. I've considered the views of the Health, Social Care and Sport Committee and wider stakeholders on this point, and I'm pleased to offer this Government amendment, which I believe complements rather than cuts across existing provision within the Bill. It requires NHS bodies, local authorities and the citizen voice body to make arrangements to co-operate to support each other to promote the activities of the citizen voice body. It also requires NHS bodies and local authorities to make arrangements to co-operate with the citizen voice body to support it in seeking the views of the public about health and social services.
Its purpose is therefore to facilitate co-operation to ensure that the citizen voice body has the support that it needs from local authorities and the NHS to reach the public, and I ask Members to support the amendment.

Angela Burns AC: I'd like to move amendment 46, tabled in my name, and I will be opposing the Government amendment 4 in order to get to my amendment, because it's an amendment that's intended to ensure there's a duty to co-operate between NHS bodies, local authorities and the citizen voice body under recommendation 17 of the committee Stage 1 report. This has been brought forward from Stage 2, as we agree with the ethos behind the amendment.
Whilst I appreciate your amendment 4 is very similar, I don't think it quite strikes the balance needed for the duty. I contend with the Minister's argument at Stage 2 that provisions under sections 17 and 18 already give the powers outlined within this amendment, as awareness raising together is not quite the same as receiving and analysing feedback from those who are receiving care from public bodies; instead, it's actually quite a narrow view. In the same vein, although amendment 4 is clearly agreeing with the necessity for a duty of co-operation, again, it focuses on awareness raising rather than collating feedback.

Rhun ap Iorwerth AC: We are comfortable with both these amendments, because they impose duties on the NHS and local authorities to co-operate with the new citizen voice body and are necessary to provide that body with the powers that it would need. We'd actually suggest that the Conservative amendment is the stronger of the two, because it also requires the NHS and local authorities to assist the citizen voice body in collecting independent feedback from people who are receiving or may receive health services or social services. Either way, we'll be supporting both.

Caroline Jones AC: We believe that both the amendments in this group are essential to the effective operation of the citizen voice body. Without a legal duty to co-operate being placed upon NHS bodies and local authorities, there is a danger that the citizen's voice will fall on deaf ears.

The Minister to reply to the debate.

Vaughan Gething AC: Yes. I thank Members for their broad support, across a range of people, for the Government amendment. I think it's worth while pointing out that the reason why we think the current Government amendment complements is that it goes to the other duties that already exist, for example section 18, the duty on NHS bodies and local authorities to provide information that it reasonably requests; the duty in section 17 for NHS bodies and local authorities to promote the awareness of the activities of the citizen voice body; and, of course, the code of practice on requests for access that we've just discussed.
When taken together, these provisions provide a strong and coherent framework for co-operation. In contrast, amendment 46 is a broad and undefined duty on NHS bodies and local authorities, and it isn't clear how that would necessarily operate. For example, on matters of service change, there may be a difference of view about how that duty to co-operate would actually be undertaken, rather than the clearer duty to provide information and to respond to reasonable requests for information. I’d ask people, therefore, to support the Government amendment and I'd ask Members not to support amendment 46.

The question is that amendment 4 be agreed to. Does any Member object? [Objection.] We therefore proceed to a vote on amendment 4, in the name of Vaughan Gething. Open the vote. Close the vote. In favour 37, one abstention, 10 against. Therefore, amendment 4 is agreed.

Amendment 4: For: 37, Against: 10, Abstain: 1
Amendment has been agreedClick to see vote results

Group 19: Citizen Voice Body—support for volunteers and staff (Amendment 44)

Group 19 is the next group of amendments and it relates to support for volunteers and staff of the citizen voice body. Amendment 44 is the lead and only amendment and I call on Angela Burns to move and speak to the amendment.

Amendment 44 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Diolch.Amendment 44, the duty to provide information, advice and training to volunteers, is my only amendment in this group. It's because, during our evidence session with community health councils, it was quite clear that community health councils currently undertake training with their members, as do their equivalents in England, namely Healthwatch, and we want this to continue. You might think, 'Oh, well, why do you need an amendment for that? Why do you need to put it into the Bill?' As I outlined at Stage 2, taken with amendment 45, on the right of entry to premises, a duty to provide information, advice and training to volunteers and staff is critical. I want to quote the chair of the North Wales Community Health Council, Geoff Ryall-Harvey, who said that
'local Healthwatch organisations get lots of support and training from Healthwatch England, and the volunteer members of Healthwatch would need to go on a training course'
before they started visiting hospitals.
So, for us, we want to make sure that this is on the face of the Bill to ensure that there's not just a continuation, but a reinforcing and an underpinning of the importance of advising and training our volunteers and staff. There's been much play during the course of this Bill that we want to have more volunteers involved and that we want to really enable them to go out there and act throughout the health services and, of course, now the social care services, and really promote and ensure that what they're doing is absolutely right.
But this is more than just simply training volunteers. It's actually about the independence of the new citizen voice body. It's about the openness of having different types of volunteers—volunteers who are not necessarily already connected with public bodies in Wales. If we want to attract and open access and encourage lots of different types of people from very different walks of life to come and act in their community, to come and act on behalf of their local citizen voice body,then we absolutely need to make the citizen voice body as outward facing as possible, and that involves training. The current CHCs have outlined many times some of the existing challenges that CHCs have found relating to recruitment requirements, and they believe very firmly that this new body, in whatever form it finally takes, must develop its arrangements in a way that encourages that access and enables people from all backgrounds.
At Stage 2, Minister, I appreciate that you attempted to reassure me that there were resources put aside for training within the Bill's RIA, which is why I withdrew it. But, despite having £92,500 set aside annually for training, I haven't received an absolute commitment from you to commit to include training within the statutory guidance and, again, I do want to hear that real training will be undertaken and that support for volunteers and staff will be a key part of moving the new citizen voice body forward. I'd just like to remind you that you did admit that in your RIA it was difficult to estimate how many volunteer members the body will require as it will be dependent on numerous factors, such as location, the skill set of volunteers and the time commitment offered. And, although you're working on the basis of the current 276 CHC volunteers, this potentially huge number of volunteers, the RIA provides for just one working time-equivalent secondee to develop all of the induction training resources for staff and volunteers during transition. I pity that poor person; I don't see how they can do it.
So, I will end my contribution on this amendment with something so ably put by the board of the community health councils. They said that this is much more than having knowledge of the NHS and social sectors—this must be about developing and ensuring
'competence and understanding of the principles and practices of effective engagement and representation'.
We would agree entirely with this assertion, Minister, and therefore we urge Members to support this amendment.

Rhun ap Iorwerth AC: We will be supporting this amendment. This amendment is common sense, but it’s also an opportunity for me to thank those who have been volunteering over the years within the community health councils. I’ve had the pleasure and privilege of meeting and having discussions with very many of them over the past years, and have witnessed the commitment that exists to ensuring that they as individual members within the body representing patients do everything they can to ensure that the voice of the most vulnerable is heard. Therefore, I’m pleased to put that on the record here this evening. And, yes, we will be supporting this amendment. So that those volunteers who have decided to give of their time can contribute as much as they possibly can, we need to ensure that they get the support and training they require, and that always leads to the need for resources.

Caroline Jones AC: In order to ensure the citizen voice body is an effective replacement for the community health councils, we must ensure it has effectively trained staff. As you're only as good as your training, it is vitally important that we place a duty upon the new body to fully equip and train all its staff and volunteers to prepare them for the conduct of duties. If we are to have strong advocates, we must ensure we provide them with the necessary skills to step into the role before them, to represent the most vulnerable often in society.

Vaughan Gething AC: I do understand the sentiment behind the amendment, but I still don't believe it's necessary and so won't be supporting it. I certainly don't disagree that any public body or, indeed, any responsible employer, would provide information, advice and training to its staff and any volunteers that perform functions on its behalf. That's an inherent part of being able to deliver on its functions effectively. I've made clear throughout scrutiny our commitment to support the citizen voice body to provide information, advice and training to its staff and volunteers, and that is illustrated by inclusion in the regulatory impact assessment of projected costs for the training of staff and volunteers.
However, I am of the view that including a provision such as this on the face of the Bill is unnecessary. I think it is unusual to assume that a public body will not support its staff and volunteers properly when they are so crucial to its mission. In fact, what we see drafted in the amendment is what you might normally expect to see in a staff or volunteer handbook, as opposed to written into legislation.
The package of support that we have outlined in the RIA demonstrates that the CVB will have the resources it needs to provide training, advice and information to both its staff and members, and it can choose to move that resource around according to its view on its needs. This recognises the importance that we place on the role of staff and volunteers to delivering the ambition that we have for the new citizen voice body.

Angela Burns to reply.

Angela Burns AC: Thank you very much, Llywydd. Actually, Minister, you're quite right in some ways: you would expect that you wouldn't have to put on the Bill a protection about training. But unfortunately, we've done it because during the course of our negotiations, during Stages 1 and 2, and all our other meetings, which you've honestly and openly held with opposition spokespeople, you've watered down the role of the citizen voice body so much from where it was and you've changed the essence of the CHCs in ways that the people who work in the CHCs and the public that the CHCs represent really see and feel.
There's a real concern that we now have a CHC that could be based anywhere and nowhere, and definitely not in your area; that we have a CHC that doesn't necessarily have the right of access to go into certain places to find out what the citizen wants, to spot problems, to make changes; that we're out there trying to recruit a whole load of volunteers who won't necessarily have the protection from litigious other parties who might take great exception; that we're going have a body that may not have the strength to speak truth to the powerful NHS and the powerful social services organisations.
And that's why something as simple and as mundane as the training was put on the face of the Bill, because there are a great many of us in this Chamber who have been trying to fight a rearguard action to try to preserve some of that integrity, that independence and that strength for the CHCs, for the new citizen voice body. Because whatever we think about the citizen voice body, and whatever political objectives there may or may not be about it, it is ultimately the voice of the citizen. I think that, in this particular aspect of the Bill, at the end of this last amendment, which I'm asking the Chamber to support, Llywydd, you and your Government and your backbenchers have watered down the voice of the citizen.

The question is that amendment 44 be agreed to. Does any Member object? [Objection.] I therefore proceed to a vote on amendment 44. Open the vote. Close the vote. In favour 20, no abstentions, 27 against. Therefore, the amendment is not agreed.

Amendment 44: For: 20, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 45, Angela Burns.

Amendment 45 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 45 be agreed to. Does any Member object? [Objection.] I therefore proceed to a vote on amendment 45. Open the vote. Close the vote. In favour 20, no abstentions, 27 against. Therefore, the amendment is not agreed.

Amendment 45: For: 20, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Amendment 46.

Amendment 46 (Angela Burns, supported by Caroline Jones) moved.

Angela Burns AC: Formally, Llywydd.

The question is that amendment 46 be agreed to. Does any Member object? [Objection.] I therefore proceed to a vote on amendment 46, in the name of Angela Burns. Open the vote. Close the vote. In favour 19, no abstentions, 27 against. Therefore, the amendment is not agreed.

Amendment 46: For: 19, Against: 27, Abstain: 0
Amendment has been rejectedClick to see vote results

Group 20: Citizen Voice Body—application of Welsh language standards (Amendment 15)

Group 20 is the next group, and it's the final group, which is to do with the application of Welsh language standards in relation to the citizen voice body. The only amendment in this group is amendment 15, and I call on the Minister to move that amendment.

Amendment 15 (Vaughan Gething) moved.

Vaughan Gething AC: Thank you, Llywydd. The purpose of this amendment is to amend the Welsh Language Standards (No. 7) Regulations 2018 to refer to a 'citizen voice body' instead of 'community health councils' and 'the board of community health councils'. This will ensure that the new body will come under the regulations on establishment and that the Welsh Language Commissioner can issue a draft compliance notice immediately.
The commissioner raised his view on the need for this amendment with me, the Minister for International Relations and Welsh Language, and the committee during Stage 2 proceedings. I've taken on board the view of the committee and I've agreed to amending the No. 7 regulations directly via the Bill, which is unusual but is the best way to ensure the citizen voice body will be subject to the standards as soon as possible. It should ensure a smooth transition from the CHCs to the new citizen voice body and aid planning during the implementation phase in relation to Welsh language requirements.
It will ensure that users will not lose their rights to access Welsh language services for any longer than what is a minimum amount of time it takes to impose those standards on the new body. This amendment would omit the entry of 'community health councils' and 'the board', which are currently listed within the No. 7 regulations, and instead include the 'citizen voice body' for health and social care in Wales. This is a significant advantage in terms of continuity and planning of approach in relation to Welsh language matters for the citizen voice body. I hope Members recognise the effect of this amendment, and I would encourage all Members to support this amendment.
And finally, in the last moment, I'd like to thank Members for their patience and the stamina of all those staying till the end.

Angela Burns AC: We supported this amendment when it was originally tabled by Helen Mary Jones at Stage 2, and we continue to support it.

Rhun ap Iorwerth AC: I'm very pleased to be able to support this amendment tabled by the Welsh Government, which has been tabled following collaboration between the Government and ourselves. The result is that we bring this new citizen voice body under the scope of Welsh language regulations, and ensure that the Welsh Language Commissioner can provide compliance notices. So, I'm pleased the Government has moved on this because, without it, it would have meant that the citizen voice body would start at a weaker starting point in terms of how it deals with the Welsh language than the bodies that it replaces. But I do make the point that it doesn't deal with the need to strengthen the provision of Welsh language care within health and social care, which is a very different issue.

Does the Minister wish to respond? No. The question is that amendment 15 be agreed to. Does any Member object? No. Therefore, amendment 15 is agreed.

Amendment agreed in accordance with Standing Order 12.36.

We have reached the end of our Stage 3 consideration of the Health and Social Care (Quality and Engagement) (Wales) Bill, and I declare that all sections and Schedules of the Bill are deemed agreed.

All sections of the Bill deemed agreed.

Point of Order

Rhun ap Iorwerth.

Rhun ap Iorwerth AC: A brief point of order.

Rhun ap Iorwerth AC: Members will have been made aware that, during this Stage 3 debate this evening, there has been confirmation of a significant increase in confirmed cases of COVID-19 in Wales: seven new infections found after contact tracing took place in relation to the man from Neath Port Talbot who tested positive at the weekend; two residents of Carmarthenshire who'd returned from Italy. Now, under Standing Order 12.16 relating to business that can be scheduled without notice, can I ask that a statement be made by the Minister for health, perhaps at the beginning of Plenary tomorrow? This is a significant development, I think, and we need to schedule room for it on the agenda as soon as possible—given that, for obvious reasons, the Minister has not been able to prepare in the last few hours to give a statement this evening.

The Minister.

Vaughan Gething AC: It is worth perhaps reflecting on the fact that questions for myself have been moved to the first item of Assembly business tomorrow afternoon. That is to ensure that not only can I answer questions to Members, but also I do, then, have time to attend the COBRA call that is taking place tomorrow afternoon with other Governments across the United Kingdom. I'm sure we'll have ample opportunity to answer questions on coronavirus—it is on the order paper in question 2—in addition to what spokespeople may wish to ask during their own questions.

Thank you. That clarifies that we will be returning to this issue first thing in our agenda tomorrow.

Thank you to everyone and goodnight.

The meeting ended at 21:49.

A Message from Her Majesty The Queen, Head of the Commonwealth

On Commonwealth occasions, it is always inspiring to be reminded of the diversity of the people and countries that make up our worldwide family. We are made aware of the many associations and influences that combine through Commonwealth connection, helping us to imagine and deliver a common future.
This is particularly striking when we see people from nations, large and small, gathering for the Commonwealth Games, for meetings of Commonwealth governments, and on Commonwealth Day. Such a blend of traditions serves to make us stronger, individually and collectively, by providing the ingredients needed for social, political and economic resilience.
Throughout my life, I have had the opportunity to see and hear how membership of the Commonwealth family means so much to those living in all parts of the world, often in places that are quite remote. Advances in technology and modern media have now enabled many more people to witness and enjoy—with remarkable immediacy—this experience of Commonwealth connection, in areas such as education, medicine and conservation.
Looking to the future, this connectivity means we are also aware, perhaps as never before, that wherever we live, our choices and actions affect the well-being of people and communities living far away, and in very different circumstances. For many, this awareness awakens a desire to employ our planet’s natural resources with greater care, and it is encouraging to see how the countries of the Commonwealth continue to devise new ways of working together to achieve prosperity, whilst protecting our planet.
As members of this very special community, on this Commonwealth Day, I hope that the people and countries of the Commonwealth will be inspired by all that we share, and move forward with fresh resolve to enhance the Commonwealth’s influence for good in our world.

QNR

Questions to the First Minister

Gareth Bennett: Will the First Minister make a statement on Welsh Government policy to combat fly-tipping?

Mark Drakeford: The Welsh Government continues to deliver our strategy 'A Fly-tipping Free Wales', funding and working with a range of partner organisations in order to secure the long-term reduction of fly-tipping in Wales.

Janet Finch-Saunders: Will the First Minister make a statement on the funding of hospices in Wales?

Mark Drakeford: The Welsh Government provides over £8.4 million annually to support specialist palliative care services across Wales.

Caroline Jones: What actions is the Welsh Government taking to ensure tenancy agreements meet the needs of tenants in social housing?

Mark Drakeford: Responsibility for the content of tenancy agreements rests with social landlords, subject to the requirements of housing law. The Renting Homes (Wales) Act 2016, once implemented, will require certain fundamental and supplementary terms to be included, drawn either from the Act or secondary legislation.

David Rees: What discussions has the First Minister had with UK Government Ministers since the UK general election regarding the future of the manufacturing sector in Wales?

Mark Drakeford: I and the Minister for Economy, Transport and North Wales meet regularly with UK Ministers to discuss a range of issues regarding the manufacturing sector.

David Melding: Will the First Minister make a statement as to what measures are in place to encourage small and medium-sized house builders back into the Welsh market?

Mark Drakeford: The Welsh Government has a strong track record in encouraging small and medium-sized house builders back into house building in Wales. We tailor our policies, offer advice and provide financial assistance to ensure businesses are supported.